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Stone GA, Fernandez M, DeSantiago A. Rural Latino health and the built environment: a systematic review. ETHNICITY & HEALTH 2022; 27:1-26. [PMID: 30999761 DOI: 10.1080/13557858.2019.1606899] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Accepted: 04/08/2019] [Indexed: 05/21/2023]
Abstract
Objective: This study systematically reviewed literature examining the influence of the rural built environment on Latinos' health outcomes and behaviour in the United States. A secondary aim of the study was to identify strategies developed to address challenges in the rural built environment affecting Latinos' health.Design: This study followed the reporting guidelines set forth by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Articles included in the final analysis clearly linked Latino health outcomes to characteristics of the rural built environment.Results: Of the nearly 2,500 articles identified in the initial search, the final review included approximately 146 full-text sources. The majority of the articles focused on aspects of Latinos' physical (n = 68), behavioural (n = 43), and mental health (n = 23).Conclusions: Rural Latino neighbourhoods in the United States possess limited access to health care, internet, transportation, and recreation infrastructure, which negatively impacts health outcomes and behaviours. Strategies developed to mitigate these issues include but are not limited to: the use of telecommunications to distribute health information; the use of community health workers and mobile clinics to increase awareness and availability of select health services; the use of worksite trainings and adaptations to the workplace; and the promotion of safety net programmes, such as the Supplemental Nutrition Programme for Women, Infants and Children (WIC). This review supports the need for a more robust research agenda documenting the health experiences of rural Latinos of various nationalities, age groups, and genders.
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Affiliation(s)
- Garrett A Stone
- Department of Parks, Recreation and Tourism Management, Clemson University, Clemson, USA
| | - Mariela Fernandez
- Department of Parks, Recreation and Tourism Management, Clemson University, Clemson, USA
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Reid A, Schenker MB. Hired farmworkers in the US: Demographics, work organisation, and services. Am J Ind Med 2016; 59:644-55. [PMID: 27400442 DOI: 10.1002/ajim.22613] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2016] [Indexed: 01/17/2023]
Abstract
OBJECTIVE Farm work is labor-intensive, physically demanding, and incurs a high risk of injury. The aim of this study was to identify characteristics of farmworkers at increased risk of adverse health outcomes to focus targeted interventions. METHODS The National Agricultural Workers Survey for 2008-2012 was used to compare characteristics associated with adverse health and safety conditions among US-born and Mexican and Central American-born Latino and Indigenous, documented and undocumented farmworkers, separately for males and females. RESULTS US-born farmworkers had more secure work, worked less onerous tasks, and earned more per hour than other categories of farmworkers. Undocumented Indigenous workers had more precarious work, worked more onerous tasks, and were more likely to do piece work, than undocumented Latino workers. DISCUSSION We highlight disparities in modifiable occupational health risk factors across groups of farmworkers that are associated with increased risks of work-related injury and poor health. Am. J. Ind. Med. 59:644-655, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Alison Reid
- School of Public Health; Curtin University; Bentley Western Australia Australia
| | - Marc B. Schenker
- Center for Occupational and Environmental Health; University of California; Davis California
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Arcury TA, Gabbard S, Bell B, Casanova V, Flocks JD, Swanberg JE, Wiggins MF. Collecting Comparative Data on Farmworker Housing and Health: Recommendations for Collecting Housing and Health Data Across Places and Time. New Solut 2015; 25:287-312. [PMID: 26315035 PMCID: PMC9109263 DOI: 10.1177/1048291115601052] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The substandard nature of the housing in which most farmworkers live has detrimental effects on their health, as well as on their children's health and development. However, little research has directly documented associations between farmworker housing and health; existing research is not always comparable due to differences in design and measurement. Comparative data can help determine actual causal links between housing characteristics and farmworker health and help to evaluate the efficacy of current housing policy. The goal of this paper is to provide guidelines promoting comparable research on farmworker housing and the association of this housing with health. This paper reviews general concepts relevant to measuring farmworker housing and health, issues that should be considered in designing farmworker housing and health research, data collection methods, and measures. It concludes with recommendations for a research agenda on farmworker housing and health.
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Affiliation(s)
- Thomas A Arcury
- Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | | | | | - Vanessa Casanova
- Southwest Center for Agricultural Health, Injury Prevention and Education, Tyler, TX, USA
| | - Joan D Flocks
- Center for Governmental Responsibility, Levin College of Law, University of Florida, Gainesville, FL, USA
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Frank AL, Liebman AK, Ryder B, Weir M, Arcury TA. Health care access and health care workforce for immigrant workers in the agriculture, forestry, and fisheries sector in the southeastern US. Am J Ind Med 2013; 56:960-74. [PMID: 23532981 DOI: 10.1002/ajim.22183] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2013] [Indexed: 01/11/2023]
Abstract
BACKGROUND The Agriculture, Forestry, and Fishery (AgFF) Sector workforce in the US is comprised primarily of Latino immigrants. Health care access for these workers is limited and increases health disparities. METHODS This article addresses health care access for immigrant workers in the AgFF Sector, and the workforce providing care to these workers. CONTENTS Immigrant workers bear a disproportionate burden of poverty and ill health and additionally face significant occupational hazards. AgFF laborers largely are uninsured, ineligible for benefits, and unable to afford health services. The new Affordable Care Act will likely not benefit such individuals. Community and Migrant Health Centers (C/MHCs) are the frontline of health care access for immigrant AgFF workers. C/MHCs offer discounted health services that are tailored to meet the special needs of their underserved clientele. C/MHCs struggle, however, with a shortage of primary care providers and staff prepared to treat occupational illness and injury among AgFF workers. A number of programs across the US aim to increase the number of primary care physicians and care givers trained in occupational health at C/MHCs. While such programs are beneficial, substantial action is needed at the national level to strengthen and expand the C/MHC system and to establish widely Medical Home models and Accountable Care Organizations. System-wide policy changes alone have the potential to reduce and eliminate the rampant health disparities experienced by the immigrant workers who sustain the vital Agricultural, Forestry, and Fishery sector in the US.
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Affiliation(s)
- Arthur L. Frank
- Department of Environmental and Occupational Health; Drexel University School of Public Health; Philadelphia; Pennsylvania
| | | | - Bobbi Ryder
- National Center for Farmworker Health; Inc.; Buda; Texas
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Quandt SA, Kucera KL, Haynes C, Klein BG, Langley R, Agnew M, Levin JL, Howard T, Nussbaum MA. Occupational health outcomes for workers in the agriculture, forestry and fishing sector: implications for immigrant workers in the southeastern US. Am J Ind Med 2013; 56:940-59. [PMID: 23450720 DOI: 10.1002/ajim.22170] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2013] [Indexed: 11/05/2022]
Abstract
BACKGROUND Workers in the Agriculture, Forestry, and Fisheries (AgFF) sector experience exposures directly related to the work itself, as well as the physical environment in which the work occurs. Health outcomes vary from immediate to delayed, and from acute to chronic. METHODS We reviewed existing literature on the health outcomes of work in the AgFF sector and identified areas where further research is needed to understand the impact of these exposures on immigrant Latino workers in the southeastern US. RESULTS Outcomes related to specific body systems (e.g., musculoskeletal, respiratory) as well as particular exposure sources (e.g., pesticides, noise) were reviewed. The most extensive evidence exists for agriculture, with a particular focus on chemical exposures. Little research in the southeastern US has examined health outcomes of exposures of immigrant workers in forestry or fisheries. CONCLUSION As the AgFF labor force includes a growing number of Latino immigrants, more research is needed to characterize a broad range of exposures and health outcomes experienced by this population, particularly in forestry and fisheries.
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Affiliation(s)
| | - Kristen L. Kucera
- Division of Occupational and Environmental Medicine; Department of Community and Family Medicine; Duke University; Durham; North Carolina
| | - Courtney Haynes
- Department of Industrial and Systems Engineering; School of Biomedical Engineering and Sciences; Virginia Tech; Blacksburg, Virginia
| | - Bradley G. Klein
- Department of Biomedical Sciences and Pathobiology; Virginia-Maryland Regional College of Veterinary Medicine; Virginia Tech; Blacksburg, Virginia
| | - Ricky Langley
- Division of Public Health; North Carolina Department of Health and Human Services; Raleigh; North Carolina
| | - Michael Agnew
- Department of Industrial and Systems Engineering; School of Biomedical Engineering and Sciences; Virginia Tech; Blacksburg, Virginia
| | - Jeffrey L. Levin
- Department of Occupational Health Sciences; University of Texas Health Science Center at Tyler; Tyler; Texas
| | | | - Maury A. Nussbaum
- Department of Industrial and Systems Engineering; School of Biomedical Engineering and Sciences; Virginia Tech; Blacksburg, Virginia
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Gustafson CJ, Feldman SR, Quandt SA, Isom S, Chen H, Spears CR, Arcury TA. The association of skin conditions with housing conditions among North Carolina Latino migrant farm workers. Int J Dermatol 2013; 53:1091-7. [PMID: 23675774 DOI: 10.1111/j.1365-4632.2012.05833.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Skin conditions are common among Latino migrant farm workers. Although many skin conditions are related to occupational exposures, poor housing conditions may also contribute to skin ailments in migrant farm workers. OBJECTIVES To evaluate the association between housing conditions and skin conditions among Latino migrant farm workers. MATERIALS AND METHODS A cross-sectional study design using interview questionnaires, home inspections, and environmental sampling was implemented to document housing quality of farm worker camps/homes and the prevalence of self-reported skin conditions in Latino migrant farm workers. Interviews were completed with 371 farm workers residing in 186 of the 226 camps (camp response rate 82.3%). RESULTS Self-reported pruritus (31%), rash (25%), scaling (12%), blisters (11%), and ingrown nails (10%) were common among the participants. Pruritus was more likely to be reported by farm workers living in dwellings without air-conditioning (P < 0.05). Rash was associated with dwellings reported to have a low humidity (P < 0.05). Scaling was more likely to be reported by farm workers living in dwellings with indoor temperatures in the thermal discomfort range (P < 0.05). No statistically significant associations were detected for indoor allergens and self-reported skin ailments among migrant farm workers. CONCLUSIONS Skin conditions are common among migrant farm workers in North Carolina. The quality of housing conditions, particularly hot, dry indoor thermal environment, demonstrated significant associations with pruritus, rash, and scaling. The impact of housing characteristics on pruritus and blisters was greatest in new migrant farm workers. Further research is needed to delineate additional housing factors that could cause or exacerbate skin diseases in farm workers.
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Affiliation(s)
- Cheryl J Gustafson
- Center for Dermatology Research, Wake Forest School of Medicine, Winston-Salem, NC, USA; Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
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Pysklywec M, McLaughlin J, Tew M, Haines T. Doctors within borders: meeting the health care needs of migrant farm workers in Canada. CMAJ 2011; 183:1039-43. [PMID: 21502349 DOI: 10.1503/cmaj.091404] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Michael Pysklywec
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario.
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Culp K, Tonelli S, Ramey SL, Donham K, Fuortes L. Preventing Heat-Related Illness Among Hispanic Farmworkers. ACTA ACUST UNITED AC 2011; 59:23-32. [DOI: 10.3928/08910162-20101228-01] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2010] [Accepted: 10/19/2010] [Indexed: 11/20/2022]
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Irby CE, Yentzer BA, Vallejos QM, Arcury TA, Quandt SA, Feldman SR. The prevalence and possible causes of contact dermatitis in farmworkers. Int J Dermatol 2010; 48:1166-70. [PMID: 20064167 DOI: 10.1111/j.1365-4632.2009.04234.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Cynthia E Irby
- Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC US0041, USA
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Vallejos QM, Quandt SA, Feldman SR, Fleischer AB, Brooks T, Cabral G, Heck J, Schulz MR, Verma A, Whalley LE, Arcury TA. Teledermatology consultations provide specialty care for farmworkers in rural clinics. J Rural Health 2010; 25:198-202. [PMID: 19785587 DOI: 10.1111/j.1748-0361.2009.00218.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
CONTEXT Rural patients have limited access to dermatologic care. Farmworkers have high rates of skin disease and limited access to care. PURPOSE This exploratory study assessed whether teledermatology consultations could help meet the needs of health care providers for farmworkers in rural clinics. METHODS Dermatologists provided 79 consultations, using store-and-forward teledermatology, to farmworkers who presented with a skin disease to rural North Carolina clinics. Clinic providers rated the value of the consultation. FINDINGS Most requests for consultations (94%) came from family nurse practitioners or physician assistants. Twelve percent of consultations were rated somewhat helpful, and the remainder helpful or very helpful. After receiving the consultation, providers changed the diagnosis in 13% of cases. The consultation led providers to contact or attempt to contact 21% of patients to change treatment recommendations. CONCLUSIONS Access to expert dermatologic services is needed by rural health care providers. Teledermatology consultations may be a helpful tool to meet this need.
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Affiliation(s)
- Quirina M Vallejos
- Department of Family and Community Medicine, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1084, USA
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Feldman SR, Vallejos QM, Quandt SA, Fleischer AB, Schulz MR, Verma A, Arcury TA. Health care utilization among migrant Latino farmworkers: the case of skin disease. J Rural Health 2009; 25:98-103. [PMID: 19166568 DOI: 10.1111/j.1748-0361.2009.00205.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
CONTEXT Skin diseases are common occupational illnesses for migrant farmworkers. Farmworkers face many barriers in accessing health care resources. PURPOSE Framed by the Health Behavior Model, the purpose of this study was to assess health care utilization for skin disease by migrant Latino farmworkers. METHODS Three hundred and four migrant and seasonal Latino farmworkers in North Carolina were enrolled in a longitudinal study of skin disease and health care utilization over a single agricultural season. Self-reported and dermatologist-diagnosed skin condition data were collected at baseline and at up to 4 follow-up assessments. Medical visit rates were compared to national norms. FINDINGS Self-reported skin problems and diagnosed skin disease were common among farmworkers. However, only 34 health care visits were reported across the entire agricultural season, and none of the visits were for skin diseases. Nevertheless, self-treatment for skin conditions was common, including use of non-prescription preparations (63%), prescription products (9%), and home remedies (6%). General medical office visits were reported in 3.2% of the assessments, corresponding to 1.6 office visits per person year. CONCLUSIONS The migrant farmworker population consists largely of young men who make little use of clinic services. Skin conditions are very common among these workers, but use of medical services for these conditions is not common. Instead, farmworkers rely primarily on self-treatment. Clinic-based studies of farmworker skin conditions will not account for most injury or disease in this population and have the potential for biased estimates.
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Affiliation(s)
- Steven R Feldman
- Department of Dermatology, School of Medicine, Wake Forest University, Winston-Salem, NC 27157-1071, USA.
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Pichardo R, Vallejos Q, Feldman SR, Schulz MR, Verma A, Quandt SA, Arcury TA. The prevalence of melasma and its association with quality of life in adult male Latino migrant workers. Int J Dermatol 2009; 48:22-6. [PMID: 19126046 DOI: 10.1111/j.1365-4632.2009.03778.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Melasma is a common condition of Latino women that detracts from their quality of life (QOL). The prevalence and impact of melasma in Latino men is not well characterized. AIM To assess the prevalence of melasma and its association with QOL in Latino men from Mexico and Central America working in the USA. METHODS The prevalence of melasma was assessed in three studies of Latino men: by direct examination in a study of 25 Latino poultry workers; by direct examination in a study of 54 Latino farm workers; and by examination of store-and-forward teledermatology images in a study of 300 Latino farm workers. QOL was assessed with a Spanish version of the Dermatology Life Quality Index (DLQI). RESULTS The prevalence of melasma was 36.0%, 7.4%, and 14.0% in the three studies. The prevalence of melasma was greatest amongst those aged 31 years and older, who were from Guatemala, and who spoke an indigenous language. The presence of melasma was associated with higher DLQI scores, indicating a poorer QOL, in the poultry worker population. CONCLUSIONS Melasma is a common condition in Latino men and is associated with a poor QOL in some affected individuals. Clinicians should be aware that melasma may be a concern for their male Latino patients. Research on the association of skin conditions with QOL amongst minority men is needed.
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Affiliation(s)
- Rita Pichardo
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157-1071, USA
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Feldman SR, Vallejos QM, Whalley LE, Quandt SA, Brooks T, Cabral G, Earp P, Bischoff W, Arcury TA. Blistering eruption in a Latino migrant farmworker. J Agromedicine 2008; 12:81-5. [PMID: 19042682 DOI: 10.1080/10599240801986322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Skin rashes are among the most common problems seen by those providing health care to agricultural workers. We present a case report of a migrant farmworker patient with a painful, blistering eruption of the axilla and adjacent skin developing after an insect bite. The possibility of infection was not initially considered, and teledermatology was helpful in making the diagnosis of bullous impetigo. This was important because initial culture confirmation was not obtained and antibiotic treatment had not been initiated. After the consultation, the impetigo was treated by empiric antibiotic coverage. The environmental conditions of migrant farmworkers raise special issues for infectious skin diseases like bullous impetigo. Crowded living conditions, lack of proper sanitary facilities, and poor accessibility to health care increase the risk of occurrence and spread of this disease. With the recent emergence of multi-drug-resistant organisms such as methicillin-resistant Staphylococcus aureus in community settings, this case report should serve to reinforce the need to recognize the possibility of infection and to obtain culture specimens at the initial visit to better treat and control this infectious skin condition.
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Hinckley M, Feldman SR, Fleischer AB, Vallejos QM, Whalley LE, Quandt SA, Heck J, Cabral G, Brooks T, Schulz MR, Arcury TA. Common Skin Disorders Seen in the Migrant Farmworker Health Care Clinic Setting. J Agromedicine 2008; 12:71-9. [DOI: 10.1080/10599240801986272] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Quandt SA, Schulz MR, Vallejos QM, Feldman SR, Verma A, Fleischer AB, Rapp SR, Arcury TA. The association of dermatologist-diagnosed and self-reported skin diseases with skin-related quality of life in Latino migrant farmworkers. Int J Dermatol 2008; 47:236-41. [PMID: 18289322 DOI: 10.1111/j.1365-4632.2008.03518.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Skin diseases are known to affect the quality of life (QoL), but data to support this are based on clinical samples. Few data document the skin-related QoL in the general population, and whether its association differs with self-reported or dermatologist-diagnosed skin ailments. Farmworkers are at high risk for skin diseases, and are an appropriate population in which to explore these associations. OBJECTIVES To compare the association between skin-related QoL and workers' self-reports of skin conditions or dermatologist-diagnosed skin diseases over the course of a work season. METHODS Three hundred and four Latino farmworkers were recruited from 45 randomly selected residential sites in North Carolina, USA, for longitudinal surveillance. The participants were interviewed up to five times at 3-week intervals and the reported skin problems and Dermatology Life Quality Index (DLQI) were recorded. Nine digital photographs were taken of each participant. A board-certified dermatologist rated each for the presence of specific skin diseases. RESULTS An impact of skin disease on QoL was reported in 16% of interviews. In multivariate analyses with self-reported skin problems, feet or skin fungus, rash, itching, and poison ivy were predictors of QoL. Dermatologist-diagnosed inflammatory diseases and pigmentary disorders were significant predictors of QoL. The association was stronger for self-reported skin problems than for dermatologist-diagnosed conditions. CONCLUSIONS In a population of farmworkers, skin problems had a clinically significant impact on QoL. Itch-related conditions and cosmetic conditions, such as acne and melasma, were important determinants of QoL. Treatment for these conditions in this population may enhance QoL.
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Affiliation(s)
- Sara A Quandt
- Division of Public Health Sciences, Department of Family and Community Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157, USA.
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Arcury TA, Vallejos QM, Schulz MR, Feldman SR, Fleischer AB, Verma A, Quandt SA. Green tobacco sickness and skin integrity among migrant Latino farmworkers. Am J Ind Med 2008; 51:195-203. [PMID: 18181197 DOI: 10.1002/ajim.20553] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Green tobacco sickness (GTS) affects approximately one-quarter of tobacco workers. The primary aim of this analysis is to expand existing knowledge of GTS risk factors by delineating the association of measures of skin integrity with the prevalence of GTS among Latino farmworkers. METHODS Data are from a longitudinal study of skin disease among 304 North Carolina Latino farmworkers conducted in 2005. RESULTS 18.4% of the farmworkers met the GTS case definition. Self-reported rash increased the odds of having GTS in the bivariate (OR 2.29, 95% CI 1.21, 4.35), and multivariate analyses (OR 3.30, CI 2.17, 5.02). Self-reported itch (OR 3.54, CI 2.38, 5.24) and superficial wounds (OR 2.49, CI 1.15, 5.39) had a significant relationship to GTS in the bivariate analysis. CONCLUSIONS These analyses extend current knowledge of GTS risk factors to include skin integrity. Farmworkers with rash and other skin conditions can protect these affected skin areas from exposure to the tobacco plant to reduce their risk of GTS.
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Affiliation(s)
- Thomas A Arcury
- Department of Family and Community Medicine, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1084, USA.
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Vallejos QM, Schulz MR, Quandt SA, Feldman SR, Galvan L, Verma A, Fleischer AB, Rapp SR, Arcury TA. Self report of skin problems among farmworkers in North Carolina. Am J Ind Med 2008; 51:204-12. [PMID: 18181182 DOI: 10.1002/ajim.20550] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND This study estimates the prevalence of self-reported skin problems among Latino farmworkers and identifies associated risk factors. METHODS The study used a longitudinal surveillance design. Participants were interviewed up to five times and reported skin problems and personal, work, and environment characteristics. Frequencies and counts were calculated for 13 skin problems. Adjusted odds ratios were obtained for six skin problems. RESULTS More than one-third of participants reported skin problems, including skin and nail fungus; sunburn; bumps, pimples, or acne; calluses; itching; rash; and insect bite. A variety of work and environment factors were associated with higher rates of skin problems. One of the strongest predictors was working in wet clothes or shoes. CONCLUSIONS Programs are needed to educate farmworkers about measures they can take to decrease their risk of skin problems. Changes in work practices and personal protective equipment provided could help decrease the prevalence of skin problems.
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Affiliation(s)
- Quirina M Vallejos
- Department of Family and Community Medicine, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1084, USA.
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Quandt SA, Schulz MR, Vallejos QM, Feldman SR, Preisser JS, Arcury TA. Skin-Related Quality of Life among Migrant Farmworkers. J Cutan Med Surg 2008; 12:1-7. [DOI: 10.2310/7750.2007.00041] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: Farmworkers in North America work in an environment likely to produce skin injuries and illnesses that affect quality of life (QOL). Objective: We identified the dimensions of skin-related QOL that were most impaired and examined predictors in a cohort of North Carolina farmworkers. Methods: We conducted a longitudinal survey of 304 Latino farmworkers across a work season (1,048 interviews). We assessed skin-related QOL using the Dermatology Life Quality Index. Results: Effects on QOL were reported in 38.7% of observations. The greatest impacts of skin impairments were seen in the Symptoms and Feelings and Work and School Subscales. In multivariate analysis, specific work tasks and high temperatures were associated with greater decrements in QOL. Conclusions: Skin disease among farmworkers is sufficiently severe to affect QOL. Future research should test the effectiveness of interventions on modifiable factors such as facilities for personal hygiene and field sanitation on skin-related QOL.
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Affiliation(s)
- Sara A. Quandt
- From the Department of Epidemiology and Prevention, Division of Public Health Sciences, Department of Family and Community Medicine, and Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC; Department of Public Health Education, University of North Carolina at Greensboro, Greensboro, NC; and Department of Biostatistics, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Mark R. Schulz
- From the Department of Epidemiology and Prevention, Division of Public Health Sciences, Department of Family and Community Medicine, and Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC; Department of Public Health Education, University of North Carolina at Greensboro, Greensboro, NC; and Department of Biostatistics, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Quirina M. Vallejos
- From the Department of Epidemiology and Prevention, Division of Public Health Sciences, Department of Family and Community Medicine, and Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC; Department of Public Health Education, University of North Carolina at Greensboro, Greensboro, NC; and Department of Biostatistics, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Steven R. Feldman
- From the Department of Epidemiology and Prevention, Division of Public Health Sciences, Department of Family and Community Medicine, and Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC; Department of Public Health Education, University of North Carolina at Greensboro, Greensboro, NC; and Department of Biostatistics, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - John S. Preisser
- From the Department of Epidemiology and Prevention, Division of Public Health Sciences, Department of Family and Community Medicine, and Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC; Department of Public Health Education, University of North Carolina at Greensboro, Greensboro, NC; and Department of Biostatistics, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Thomas A. Arcury
- From the Department of Epidemiology and Prevention, Division of Public Health Sciences, Department of Family and Community Medicine, and Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC; Department of Public Health Education, University of North Carolina at Greensboro, Greensboro, NC; and Department of Biostatistics, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
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Linos A, Kirch W. Promoting Health for Working Women—Communicable Diseases. PROMOTING HEALTH FOR WORKING WOMEN 2008. [PMCID: PMC7121744 DOI: 10.1007/978-0-387-73038-7_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Athena Linos
- Department of Hygiene, Epidemiology, and Medical Statistics School of Medicine, National and Kapodistrian University of Athens, 75 M. Asias Street, Goudi, Athens 115 27
| | - Wilhelm Kirch
- Research Association Public Health Saxony and Saxony-Anhalt, Medical Faculty Carl Gustav Carus Technische Universität Dresden, Fiedlerstr. 27, 0/307 Dresden Germany
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Abraham NF, Feldman SR, Vallejos Q, Whalley LE, Brooks T, Cabral G, Earp P, Fleischer AB, Quandt SA, Arcury TA. Contact dermatitis in tobacco farmworkers. Contact Dermatitis 2007; 57:40-3. [PMID: 17577356 DOI: 10.1111/j.1600-0536.2007.01148.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Occupational skin disease is highly prevalent among agricultural workers. Tobacco cultivation and harvest are particularly hazardous for farmworkers. We report 5 migrant Latino farmworkers in North Carolina with contact dermatitis related to tobacco work. These cases show a characteristic distribution of contact dermatitis; the flexural and medial surfaces of the upper extremities were affected in each case, whereas most cases showed some involvement of the torso and axilla. This pattern most likely reflects a common occupational practice of holding the tobacco leaves under the arm and pressed against the body during harvesting.
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Affiliation(s)
- Nina F Abraham
- Center for Dermatology Research, Elm City, NC 27822, USA
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Arcury TA, Vallejos QM, Feldman SR, Quandt SA. Treating skin disease: self-management behaviors of Latino farmworkers. J Agromedicine 2007; 11:27-35. [PMID: 17135140 DOI: 10.1300/j096v11n02_06] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Latino migrant and seasonal farmworkers experience high rates of skin disease that result from their working and living conditions. Knowledge of the ways farmworkers treat skin disease symptoms will provide a foundation for developing culturally appropriate health education, improving the delivery of health services, and improving occupational health policy for agricultural workers. The purpose of this paper is to describe skin disease self-management practices among Latino migrant and seasonal farmworkers in North Carolina. This analysis uses a qualitative design based on in-depth interviews with 30 Latino farmworkers (six females, 24 males). Computer assisted, systematic procedures are used to analyze the verbatim transcripts of these interviews. Participants shared a consistent set of health self-management actions in treating skin disease. These actions were within the domains of self-care and medical care. A model of skin disease self-management among Latino farmworkers includes the self-care actions of hygiene, use of home remedies and use of over-the-counter remedies, with farmworkers often combining different domains of self-care. While farmworkers acknowledge the benefits of medical care, they are also mindful of barriers to its use, including cost, transportation and language. The large percentage of farmworkers who experience skin problems indicates that health outreach workers who serve this population need to provide education on preventing and treating skin problems, and they need to recommend to farmworkers appropriate over-the-counter medicines for the treatment of these skin problems. Appropriate medical care for treating skin problems that are dangerous and reduce farmworkers' quality-of-life needs to be made available to this population.
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Affiliation(s)
- Thomas A Arcury
- Department of Family and Community Medicine, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1084, USA.
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