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Flunker JC, Spector JT, Blancas M, Briggs NL, Flores M, Whitaker CR, Schoonover T, Cardoso T. Farmworker-Relevant Heat Exposure in Different Crop and Shade Conditions. J Agromedicine 2024; 29:547-560. [PMID: 38874305 PMCID: PMC11410529 DOI: 10.1080/1059924x.2024.2365647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Abstract
OBJECTIVES Agricultural workers are at risk of heat-related illness, which is preventable. Few field studies have compared farmworker-relevant heat exposure in different conditions. We examined heat exposure over time in different potential shade and work locations to inform future occupational heat prevention approaches. METHODS We assessed heat exposure in Eastern Washington State (WA) cherry and grape fields in August 2022. QUESTemp° monitors recorded Wet Bulb Globe Temperature (WBGT) and Black Globe Temperature (BGT) every 10 min from approximately 07:00-14:00 for three days in the center of crop rows (mid-row), under portable shade structures (shade), and in open field (open) locations. Linear mixed effects regression (LMER) models compared WBGT and BGT among field locations. Hourly time-weighted average WBGT and comparisons with occupational exposure limits (OELs) were computed for different hypothetical work-rest cycles during the hottest sampling hours, assuming different worker effort levels, rest locations (mid-row versus shade), and acclimatization statuses. RESULTS Across all crops and locations during the study period, the mean/SD air temperature was 31°C (88°F)/3.9°C (6.9°F), with a maximum temperature of 39°C (102°F) and a mean/SD relative humidity of 30%/9.6%. LMER models suggested no significant difference in mid-row versus open WBGT but significantly lower WBGT in shade versus open locations for both cherries (main effect -5.14: 95% confidence interval [CI] -6.97,-3.32) and grapes (-6.20: 95%CI -7.73,-4.67), though this difference diminished over the course of the day. BGT was significantly higher in the mid-row than the shade (cherries main effect 14.33: 95%CI 9.52,19.13 and grapes 17.10: 95%CI 13.44,20.75). During the hottest sampling hour, the exceedances of OELs were reduced with assumptions of increased shaded break lengths, reduced effort level, and acclimatization. CONCLUSIONS Shade canopies, but not the crops studied, provided significant reductions in heat exposure. We observed increased protection from heat assuming longer shaded breaks and reduced effort levels. Results highlight the need for additional field research on the effectiveness, feasibility, and acceptability of different shade types and work-rest cycles to guide employer optimization of best practices for worker protections, including acclimatization before high heat, sufficient shaded rest time, reduced effort levels as the day warms, and avoiding work in peak heat.
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Affiliation(s)
- John C Flunker
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - June T Spector
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
- Department of Labor and Industries, Safety & Health Assessment and Research for Prevention (SHARP) Program, Tumwater, WA, USA
| | - Maria Blancas
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Nicole L Briggs
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Miriam Flores
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Carolyn Reeb- Whitaker
- Department of Labor and Industries, Safety & Health Assessment and Research for Prevention (SHARP) Program, Tumwater, WA, USA
| | - Todd Schoonover
- Department of Labor and Industries, Safety & Health Assessment and Research for Prevention (SHARP) Program, Tumwater, WA, USA
| | - Tamre Cardoso
- Department of Statistics, University of Washington, Seattle, WA, USA
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Wuellner S, Turner K, Spector JT. Emergency department visits for heat-related illness among workers: Occupational health surveillance using Washington syndromic surveillance data. Am J Ind Med 2024. [PMID: 39221707 DOI: 10.1002/ajim.23650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 08/12/2024] [Accepted: 08/15/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Information on worker occupation and industry is critical to understanding the occupational risks of heat-related illness (HRI), yet few syndromic surveillance systems capture these key data elements. This study evaluates the work data reported through Washington syndromic surveillance for its utility in characterizing HRI ED visits by industry and occupation. METHODS Standard industry and occupation codes were assigned to employer name and occupation descriptions reported in Washington ED visit records maintained within the state's syndromic surveillance system, for visits involving HRI in 2020-2022. HRI ED visits involving workplace heat exposure were identified based on discharge diagnoses or on keywords in the triage note or chief complaint fields. HRI ED visits were summarized by patient characteristics, and visit rates were calculated by industry and occupation. RESULTS Employer name or occupation descriptions were reported in 21.5% of HRI ED records among patients age 16 and older, and in 41.2% of records with mention of heat exposure at work. Twice as many records were classified for industry as for occupation. Agriculture, forestry, fishing, and hunting and transportation and warehousing had the highest rates of HRI ED visits. Specific industries with the highest rates included support activities for agriculture and forestry, the postal service, and fruit and vegetable preserving and specialty food manufacturing. CONCLUSION Syndromic surveillance data are a valuable source of occupational health surveillance information when work characteristics are reported, enhancing our understanding of the occupational risks of injuries and illnesses.
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Affiliation(s)
- Sara Wuellner
- Washington State Department of Labor & Industries, SHARP Program, Olympia, Washington, USA
| | - Kali Turner
- Washington State Department of Health, RHINO Program, Olympia, Washington, USA
| | - June T Spector
- Washington State Department of Labor & Industries, SHARP Program, Olympia, Washington, USA
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3
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Gibb K, Beckman S, Vergara XP, Heinzerling A, Harrison R. Extreme Heat and Occupational Health Risks. Annu Rev Public Health 2024; 45:315-335. [PMID: 38166501 DOI: 10.1146/annurev-publhealth-060222-034715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2024]
Abstract
Climate change poses a significant occupational health hazard. Rising temperatures and more frequent heat waves are expected to cause increasing heat-related morbidity and mortality for workers across the globe. Agricultural, construction, military, firefighting, mining, and manufacturing workers are at particularly high risk for heat-related illness (HRI). Various factors, including ambient temperatures, personal protective equipment, work arrangements, physical exertion, and work with heavy equipment may put workers at higher risk for HRI. While extreme heat will impact workers across the world, workers in low- and middle-income countries will be disproportionately affected. Tracking occupational HRI will be critical to informing prevention and mitigation strategies. Renewed investment in these strategies, including workplace heat prevention programs and regulatory standards for indoor and outdoor workers, will be needed. Additional research is needed to evaluate the effectiveness of interventions in order to successfully reduce the risk of HRI in the workplace.
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Affiliation(s)
- Kathryn Gibb
- Occupational Health Branch, California Department of Public Health, Richmond, California, USA;
| | - Stella Beckman
- Occupational Health Branch, California Department of Public Health, Richmond, California, USA;
| | | | - Amy Heinzerling
- Occupational Health Branch, California Department of Public Health, Richmond, California, USA;
| | - Robert Harrison
- Occupational Health Branch, California Department of Public Health, Richmond, California, USA;
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Ettinger AK, Bratman GN, Carey M, Hebert R, Hill O, Kett H, Levin P, Murphy-Williams M, Wyse L. Street trees provide an opportunity to mitigate urban heat and reduce risk of high heat exposure. Sci Rep 2024; 14:3266. [PMID: 38351140 PMCID: PMC10864265 DOI: 10.1038/s41598-024-51921-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 01/11/2024] [Indexed: 02/16/2024] Open
Abstract
Climate change is exacerbating the need for urban greening and the associated environmental and human well-being benefits. Trees can help mitigate urban heat, but more detailed understanding of cooling effects of green infrastructure are needed to guide management decisions and deploy trees as effective and equitable climate adaptation infrastructure. We investigated how urban trees affect summer air temperature along sidewalks within a neighborhood of Tacoma, Washington, USA, and to what extent urban trees reduce risks of high summer temperatures (i.e., the levels regulated by state outdoor heat exposure rules intended to reduce heat-related illnesses). Air temperature varied by 2.57 °C, on average, across our study area, and the probability of daytime temperatures exceeding regulated high temperature thresholds was up to five times greater in locations with no canopy cover within 10 m compared to those with 100% cover. Air temperatures decreased linearly with increasing cover within 10 m, suggesting that every unit of added tree cover can help cool the air. Our findings highlight the value of trees in mitigating urban heat, especially given expected warming with climate change. Protecting existing urban trees and increasing tree cover (e.g., by planting street trees), are important actions to enhance climate change resilience of urban areas.
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Affiliation(s)
- Ailene K Ettinger
- The Nature Conservancy of Washington, 74 Wall Street, Seattle, WA, 98121, USA.
| | - Gregory N Bratman
- School of Environmental and Forest Sciences, University of Washington, Seattle, WA, 98195, USA
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, 98195, USA
| | - Michael Carey
- Urban Forest Program, City of Tacoma, Tacoma, WA, USA
| | - Ryan Hebert
- Urban Forest Program, City of Tacoma, Tacoma, WA, USA
| | - Olivia Hill
- School of Environmental and Forest Sciences, University of Washington, Seattle, WA, 98195, USA
| | - Hannah Kett
- The Nature Conservancy of Washington, 74 Wall Street, Seattle, WA, 98121, USA
| | - Phillip Levin
- School of Marine and Environmental Affairs, University of Washington, Seattle, WA, 98195, USA
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Hess JJ, Sheehan TJ, Miller A, Cunningham R, Errett NA, Isaksen TB, Vogel J, Ebi KL. A novel climate and health decision support platform: Approach, outputs, and policy considerations. ENVIRONMENTAL RESEARCH 2023; 234:116530. [PMID: 37394172 DOI: 10.1016/j.envres.2023.116530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 06/14/2023] [Accepted: 06/29/2023] [Indexed: 07/04/2023]
Abstract
BACKGROUND The adverse health impacts of climate change are increasingly apparent and the need for adaptation activities is pressing. Risks, drivers, and decision contexts vary significantly by location, and high-resolution, place-based information is needed to support decision analysis and risk reduction efforts at scale. METHODS Using the Intergovernmental Panel on Climate Change (IPCC) risk framework, we developed a causal pathway linking heat with a composite outcome of heat-related morbidity and mortality. We used an existing systematic literature review to identify variables for inclusion and the authors' expert judgment to determine variable combinations in a hierarchical model. We parameterized the model for Washington state using observational (1991-2020 and June 2021 extreme heat event) and scenario-driven temperature projections (2036-2065), compared outputs against relevant existing indices, and analyzed sensitivity to model structure and variable parameterization. We used descriptive statistics, maps, visualizations and correlation analyses to present results. RESULTS The Climate and Health Risk Tool (CHaRT) heat risk model contains 25 primary hazard, exposure, and vulnerability variables and multiple levels of variable combinations. The model estimates population-weighted and unweighted heat health risk for selected periods and displays estimates on an online visualization platform. Population-weighted risk is historically moderate and primarily limited by hazard, increasing significantly during extreme heat events. Unweighted risk is helpful in identifying lower population areas that have high vulnerability and hazard. Model vulnerability correlate well with existing vulnerability and environmental justice indices. DISCUSSION The tool provides location-specific insights into risk drivers and prioritization of risk reduction interventions including population-specific behavioral interventions and built environment modifications. Insights from causal pathways linking climate-sensitive hazards and adverse health impacts can be used to generate hazard-specific models to support adaptation planning.
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Affiliation(s)
- Jeremy J Hess
- Center for Health and the Global Environment, University of Washington, Seattle, WA, USA; Department of Emergency Medicine, School of Medicine, University of Washington, Seattle, WA, USA; Department of Environmental and Occupational Health Science, School of Public Health, University of Washington, Seattle, WA, USA; Department of Global Health, Schools of Medicine and Public Health, University of Washington, Seattle, WA, USA.
| | - Timothy J Sheehan
- Center for Health and the Global Environment, University of Washington, Seattle, WA, USA; Department of Environmental and Occupational Health Science, School of Public Health, University of Washington, Seattle, WA, USA
| | - Alyssa Miller
- Center for Health and the Global Environment, University of Washington, Seattle, WA, USA; Department of Environmental and Occupational Health Science, School of Public Health, University of Washington, Seattle, WA, USA
| | | | - Nicole A Errett
- Center for Health and the Global Environment, University of Washington, Seattle, WA, USA; Department of Environmental and Occupational Health Science, School of Public Health, University of Washington, Seattle, WA, USA
| | - Tania Busch Isaksen
- Center for Health and the Global Environment, University of Washington, Seattle, WA, USA; Department of Environmental and Occupational Health Science, School of Public Health, University of Washington, Seattle, WA, USA
| | - Jason Vogel
- Climate Impacts Group, College of the Environment, University of Washington, Seattle, WA, USA
| | - Kristie L Ebi
- Center for Health and the Global Environment, University of Washington, Seattle, WA, USA; Department of Environmental and Occupational Health Science, School of Public Health, University of Washington, Seattle, WA, USA; Department of Global Health, Schools of Medicine and Public Health, University of Washington, Seattle, WA, USA
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De Sario M, de'Donato FK, Bonafede M, Marinaccio A, Levi M, Ariani F, Morabito M, Michelozzi P. Occupational heat stress, heat-related effects and the related social and economic loss: a scoping literature review. Front Public Health 2023; 11:1173553. [PMID: 37601227 PMCID: PMC10434255 DOI: 10.3389/fpubh.2023.1173553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 06/01/2023] [Indexed: 08/22/2023] Open
Abstract
Introduction While there is consistent evidence on the effects of heat on workers' health and safety, the evidence on the resulting social and economic impacts is still limited. A scoping literature review was carried out to update the knowledge about social and economic impacts related to workplace heat exposure. Methods The literature search was conducted in two bibliographic databases (Web of Science and PubMed), to select publications from 2010 to April 2022. Results A total of 89 studies were included in the qualitative synthesis (32 field studies, 8 studies estimating healthcare-related costs, and 49 economic studies). Overall, consistent evidence of the socioeconomic impacts of heat exposure in the workplace emerges. Actual productivity losses at the global level are nearly 10% and are expected to increase up to 30-40% under the worst climate change scenario by the end of the century. Vulnerable regions are mainly low-latitude and low- and middle-income countries with a greater proportion of outdoor workers but include also areas from developed countries such as southern Europe. The most affected sectors are agriculture and construction. There is limited evidence regarding the role of cooling measures and changes in the work/rest schedule in mitigating heat-related productivity loss. Conclusion The available evidence highlights the need for strengthening prevention efforts to enhance workers' awareness and resilience toward occupational heat exposure, particularly in low- and middle-income countries but also in some areas of developed countries where an increase in frequency and intensity of heat waves is expected under future climate change scenarios.
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Affiliation(s)
- Manuela De Sario
- Department of Epidemiology Lazio Regional Health Service, Rome, Italy
| | | | - Michela Bonafede
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Rome, Italy
| | - Alessandro Marinaccio
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Rome, Italy
| | - Miriam Levi
- Epidemiology Unit, Department of Prevention, Central Tuscany Local Health Authority, Florence, Italy
| | - Filippo Ariani
- Regional Centre for the Analysis of Data on Occupational and Work-Related Injuries and Diseases, Central Tuscany Local Health Authority, Florence, Italy
| | - Marco Morabito
- Institute of Bioeconomy, National Research Council (IBE-CNR), Florence, Italy
| | - Paola Michelozzi
- Department of Epidemiology Lazio Regional Health Service, Rome, Italy
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Spector JT, Sampson L, Flunker JC, Adams D, Bonauto DK. Occupational heat-related illness in Washington State: A descriptive study of day of illness and prior day ambient temperatures among cases and clusters, 2006-2021. Am J Ind Med 2023; 66:623-636. [PMID: 37291066 PMCID: PMC10330917 DOI: 10.1002/ajim.23506] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 05/19/2023] [Indexed: 06/10/2023]
Abstract
BACKGROUND Insufficient heat acclimatization is a risk factor for heat-related illness (HRI) morbidity, particularly during periods of sudden temperature increase. We sought to characterize heat exposure on days before, and days of, occupational HRIs. METHODS A total of 1241 Washington State workers' compensation State Fund HRI claims from 2006 to 2021 were linked with modeled parameter-elevation regressions on independent slopes model (PRISM) meteorological data. We determined location-specific maximum temperatures (Tmax,PRISM ) on the day of illness (DOI) and prior days, and whether the Tmax,PRISM was ≥10.0°F (~5.6°C) higher than the average of past 5 days ("sudden increase") for each HRI claim. Claims occurring on days with ≥10 HRI claims ("clusters") were compared with "non-cluster" claims using t tests and χ2 tests. RESULTS Seventy-six percent of analyzed HRI claims occurred on days with a Tmax,PRISM ≥ 80°F. Claims occurring on "cluster" days, compared to "non-cluster" days, had both a significantly higher mean DOI Tmax,PRISM (99.3°F vs. 85.8°F [37.4°C vs. 29.9°C], t(148) = -18, p < 0.001) and a higher proportion of "sudden increase" claims (80.2% vs. 24.3%, χ2 [1] = 132.9, p < 0.001). Compared to "cluster" days, HRI claims occurring during the 2021 Pacific Northwest "heat dome" had a similar increased trajectory of mean Tmax,PRISM on the days before the DOI, but with higher mean Tmax,PRISM. CONCLUSIONS: Occupational HRI risk assessments should consider both current temperatures and changes in temperatures relative to prior days. Heat prevention programs should include provisions to address acclimatization and, when increases in temperature occur too quickly to allow for sufficient acclimatization, additional precautions.
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Affiliation(s)
- June T. Spector
- Safety and Health Assessment and Research for Prevention (SHARP) Program, Washington State Department of Labor and Industries, Olympia, Washington, USA
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA
| | - Luke Sampson
- Safety and Health Assessment and Research for Prevention (SHARP) Program, Washington State Department of Labor and Industries, Olympia, Washington, USA
- CSTE Applied Epidemiology Fellowship Program, Council of State and Territorial Epidemiologists, Atlanta, Georgia, USA
| | - John C. Flunker
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA
| | - Darrin Adams
- Safety and Health Assessment and Research for Prevention (SHARP) Program, Washington State Department of Labor and Industries, Olympia, Washington, USA
| | - David K. Bonauto
- Safety and Health Assessment and Research for Prevention (SHARP) Program, Washington State Department of Labor and Industries, Olympia, Washington, USA
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Schulte PA, Jacklitsch BL, Bhattacharya A, Chun H, Edwards N, Elliott KC, Flynn MA, Guerin R, Hodson L, Lincoln JM, MacMahon KL, Pendergrass S, Siven J, Vietas J. Updated assessment of occupational safety and health hazards of climate change. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2023; 20:183-206. [PMID: 37104117 PMCID: PMC10443088 DOI: 10.1080/15459624.2023.2205468] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Workers, particularly outdoor workers, are among the populations most disproportionately affected by climate-related hazards. However, scientific research and control actions to comprehensively address these hazards are notably absent. To assess this absence, a seven-category framework was developed in 2009 to characterize the scientific literature published from 1988-2008. Using this framework, a second assessment examined the literature published through 2014, and the current one examines literature from 2014-2021. The objectives were to present literature that updates the framework and related topics and increases awareness of the role of climate change in occupational safety and health. In general, there is substantial literature on worker hazards related to ambient temperatures, biological hazards, and extreme weather but less on air pollution, ultraviolet radiation, industrial transitions, and the built environment. There is growing literature on mental health and health equity issues related to climate change, but much more research is needed. The socioeconomic impacts of climate change also require more research. This study illustrates that workers are experiencing increased morbidity and mortality related to climate change. In all areas of climate-related worker risk, including geoengineering, research is needed on the causality and prevalence of hazards, along with surveillance to identify, and interventions for hazard prevention and control.
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Affiliation(s)
- P. A. Schulte
- Advanced Technologies and Laboratories International, Inc, Cincinnati, Ohio
| | - B. L. Jacklitsch
- Centers for Disease Control and Prevention (CDC), National Institute for Occupational Safety and Health (NIOSH), Cincinnati, Ohio
| | - A. Bhattacharya
- Centers for Disease Control and Prevention (CDC), National Institute for Occupational Safety and Health (NIOSH), Cincinnati, Ohio
| | - H. Chun
- Centers for Disease Control and Prevention (CDC), National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Atlanta, Georgia
| | - N. Edwards
- Centers for Disease Control and Prevention (CDC), National Institute for Occupational Safety and Health (NIOSH), Morgantown, West Virginia
| | - K. C. Elliott
- Centers for Disease Control and Prevention (CDC), National Institute for Occupational Safety and Health (NIOSH), Anchorage, Alaska
| | - M. A. Flynn
- Centers for Disease Control and Prevention (CDC), National Institute for Occupational Safety and Health (NIOSH), Cincinnati, Ohio
| | - R. Guerin
- Centers for Disease Control and Prevention (CDC), National Institute for Occupational Safety and Health (NIOSH), Cincinnati, Ohio
| | - L. Hodson
- Centers for Disease Control and Prevention (CDC), National Institute for Occupational Safety and Health (NIOSH) (retired), Cincinnati, Ohio
| | - J. M. Lincoln
- Centers for Disease Control and Prevention (CDC), National Institute for Occupational Safety and Health (NIOSH), Cincinnati, Ohio
| | - K. L. MacMahon
- Centers for Disease Control and Prevention (CDC), National Institute for Occupational Safety and Health (NIOSH), Cincinnati, Ohio
| | - S. Pendergrass
- Centers for Disease Control and Prevention (CDC), National Institute for Occupational Safety and Health (NIOSH) (retired), Cincinnati, Ohio
| | - J. Siven
- Centers for Disease Control and Prevention (CDC), National Institute for Occupational Safety and Health (NIOSH), Cincinnati, Ohio
| | - J. Vietas
- Centers for Disease Control and Prevention (CDC), National Institute for Occupational Safety and Health (NIOSH), Cincinnati, Ohio
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Marquez D, Krenz JE, Santos EC, Torres E, Palmández P, Sampson PD, Blancas M, Carmona J, Spector JT. The Effect of Participatory Heat Education on Agricultural Worker Knowledge. J Agromedicine 2023; 28:187-198. [PMID: 35345983 PMCID: PMC9573936 DOI: 10.1080/1059924x.2022.2058667] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Farmworkers disproportionately experience preventable adverse health effects from heat exposure. We sought to evaluate the effect of participatory heat education on farmworker knowledge. METHODS We conducted a parallel, comparison group intervention study to investigate the effectiveness of a Spanish/English participatory, culturally-tailored, heat education-based intervention on farmworker heat knowledge in the Summer 2019. We used convenience sampling to recruit adult outdoor farmworkers from Central/Eastern Washington State, USA. Crews were randomized to receive the intervention (n = 40 participants) versus not receive the intervention (n = 43 participants). We assessed changes in heat knowledge, scored on a scale from 0 to 11, between baseline, immediate post-intervention, and post-season, which was approximately three months after baseline, using the Wilcoxon signed-rank test. We compared differences in knowledge scores from baseline to post-season between groups using analysis of variance. RESULTS Average knowledge scores improved from 4.6 (standard deviation [sd] 1.5) to 6.3 (sd 2.0) pre to post season in the intervention group (p < 0.001). There was a greater improvement in pre-post knowledge scores in the intervention (average difference 1.6, sd 2.0) versus the comparison group (average difference 0.41, sd 1.7) (p = 0.04). CONCLUSIONS Participatory heat training was effective in improving farmworker heat knowledge over the course of a summer season. Results of this study will be used to guide heat prevention efforts for farmworkers. TRIAL REGISTRATION ClinicalTrials.gov Registration Number: NCT04234802.
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Affiliation(s)
- Diana Marquez
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Jennifer E. Krenz
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | | | - Elizabeth Torres
- Northwest Communities Education Center/Radio KDNA, Granger, WA, USA
| | - Pablo Palmández
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Paul D. Sampson
- Department of Statistics, University of Washington, Seattle, WA, USA
| | - Maria Blancas
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Jose Carmona
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - June T. Spector
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
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Comi M, Becot F, Bendixsen C. Automation, Climate Change, and the Future of Farm Work: Cross-Disciplinary Lessons for Studying Dynamic Changes in Agricultural Health and Safety. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4778. [PMID: 36981685 PMCID: PMC10049460 DOI: 10.3390/ijerph20064778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 02/24/2023] [Accepted: 02/28/2023] [Indexed: 06/18/2023]
Abstract
In this review, we first assess the state of agricultural health and safety research as it pertains to the dynamic challenges facing automating agriculture on a warming planet. Then, we turn to social science fields such as rural sociology, science and technology studies, and environmental studies to leverage relevant insights on the introduction of new technologies, environmental risks, and associated workplace hazards. Increased rates of automation in agriculture alongside new risks associated with climate change create the need for anticipatory governance and adaptive research to study novel mechanisms of worker health and safety. The use of the PRISMA framework led to the 137 articles for our review. We identify three themes in the literature on agricultural health and safety: (1) adoption outcomes, (2) discrete cases of health risks, and (3) an emphasis on care and wellbeing in literature on dairy automation Our review led to the identification of research gaps, noting that current research (a) tends to examine these forces separately, instead of together, (b) has not made robust examination of these forces as socially embedded, and (c) has hesitated to examine the broad, transferable themes for how these forces work across industries. In response to these gaps, we suggest that attention to outside disciplines may provide agricultural health and safety research with a toolset to examine needed inquiry into the multiplicity of experiences of rural stakeholders, the industry specific problems arising from automation and climate change, and the socially embedded aspects of agricultural work in the future.
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Pinkerton LE, Bertke S, Dahm MM, Kubale TL, Siegel MR, Hales TR, Yiin JH, Purdue MP, Beaumont JJ, Daniels RD. End-stage renal disease incidence in a cohort of US firefighters from San Francisco, Chicago, and Philadelphia. Am J Ind Med 2022; 65:975-984. [PMID: 36268894 PMCID: PMC9828160 DOI: 10.1002/ajim.23435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 09/29/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Firefighters perform strenuous work in hot environments, which may increase their risk of chronic kidney disease. The purpose of this study was to evaluate the risk of end-stage renal disease (ESRD) and types of ESRD among a cohort of US firefighters compared to the US general population, and to examine exposure-response relationships. METHODS ESRD from 1977 through 2014 was identified through linkage with Medicare data. ESRD incidence in the cohort compared to the US population was evaluated using life table analyses. Associations of all ESRD, systemic ESRD, hypertensive ESRD, and diabetic ESRD with exposure surrogates (exposed days, fire runs, and fire hours) were examined in Cox proportional hazards models adjusted for attained age (the time scale), race, birth date, fire department, and employment duration. RESULTS The incidence of all ESRD was less than expected (standardized incidence ratio (SIR) = 0.79; 95% confidence interval = 0.69-0.89, observed = 247). SIRs for ESRD types were not significantly increased. Positive associations of all ESRD, systemic ESRD, and hypertensive ESRD with exposed days were observed: however, 95% confidence intervals included one. CONCLUSIONS We found little evidence of increased risk of ESRD among this cohort of firefighters. Limitations included the inability to evaluate exposure-response relationships for some ESRD types due to small observed numbers, the limitations of the surrogates of exposure, and the lack of information on more sensitive outcome measures for potential kidney effects.
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Affiliation(s)
- Lynne E. Pinkerton
- MaximusMcLeanVirginiaUSA
- Division of Field Studies and EngineeringNational Institute for Occupational Safety and HealthCincinnatiOhioUSA
| | - Stephen Bertke
- Division of Field Studies and EngineeringNational Institute for Occupational Safety and HealthCincinnatiOhioUSA
| | - Matthew M. Dahm
- Division of Field Studies and EngineeringNational Institute for Occupational Safety and HealthCincinnatiOhioUSA
| | - Travis L. Kubale
- World Trade Center Health ProgramNational Institute for Occupational Safety and HealthWashingtonDistrict of ColumbiaUSA
| | - Miriam R. Siegel
- Division of Field Studies and EngineeringNational Institute for Occupational Safety and HealthCincinnatiOhioUSA
| | - Thomas R. Hales
- Division of Safety ResearchNational Institute for Occupational Safety and HealthDenverColoradoUSA
| | - James H. Yiin
- Office of Extramural ProgramsNational Institute for Occupational Safety and HealthAtlantaGeorgiaUSA
| | - Mark P. Purdue
- Division of Cancer Epidemiology and GeneticsNational Cancer InstituteRockvilleMarylandUSA
| | - James J. Beaumont
- Department of Public Health SciencesUniversity of California DavisDavisCaliforniaUSA
| | - Robert D. Daniels
- World Trade Center Health ProgramNational Institute for Occupational Safety and HealthWashingtonDistrict of ColumbiaUSA
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Chavez Santos E, Spector JT, Egbert J, Krenz J, Sampson PD, Palmández P, Torres E, Blancas M, Carmona J, Jung J, Flunker JC. The effect of the participatory heat education and awareness tools (HEAT) intervention on agricultural worker physiological heat strain: results from a parallel, comparison, group randomized study. BMC Public Health 2022; 22:1746. [PMID: 36104813 PMCID: PMC9476265 DOI: 10.1186/s12889-022-14144-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 09/06/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Farmworkers are at risk of heat-related illness (HRI). We sought to: 1) evaluate the effectiveness of farmworker Spanish/English participatory heat education and a supervisor decision-support mobile application (HEAT intervention) on physiological heat strain; and 2) describe factors associated with HRI symptoms reporting. METHODS We conducted a parallel, comparison group intervention study from May-September of 2019 in Central/Eastern Washington State, USA. We used convenience sampling to recruit adult outdoor farmworkers and allocated participating crews to intervention (n = 37 participants) and alternative-training comparison (n = 38 participants) groups. We measured heat strain monthly using heart rate and estimated core body temperature to compute the maximum work-shift physiological strain index (PSImax) and assessed self-reported HRI symptoms using a weekly survey. Multivariable linear mixed effects models were used to assess associations of the HEAT intervention with PSImax, and bivariate mixed models were used to describe factors associated with HRI symptoms reported (0, 1, 2+ symptoms), with random effects for workers. RESULTS We observed larger decreases in PSImax in the intervention versus comparison group for higher work exertion levels (categorized as low, low/medium-low, and high effort), after adjustment for maximum work-shift ambient Heat Index (HImax), but this was not statistically significant (interaction - 0.91 for high versus low/medium-low effort, t = - 1.60, p = 0.11). We observed a higher PSImax with high versus low/medium-low effort (main effect 1.96, t = 3.81, p < 0.001) and a lower PSImax with older age (- 0.03, t = - 2.95, p = 0.004), after covariate adjustment. There was no clear relationship between PSImax and the number of HRI symptoms reported. Reporting more symptoms was associated with older age, higher HImax, 10+ years agricultural work, not being an H-2A guest worker, and walking > 3 min to get to the toilet at work. CONCLUSIONS Effort level should be addressed in heat management plans, for example through work/rest cycles, rotation, and pacing, in addition to education and other factors that influence heat stress. Both symptoms and indicators of physiological heat strain should be monitored, if possible, during periods of high heat stress to increase the sensitivity of early HRI detection and prevention. Structural barriers to HRI prevention must also be addressed. TRIAL REGISTRATION ClinicalTrials.gov Registration Number: NCT04234802 , date first posted 21/01/2020.
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Affiliation(s)
- Erica Chavez Santos
- Department of Health Systems and Population Health, University of Washington, Seattle, WA, USA
| | - June T Spector
- Department of Environmental and Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, Seattle, WA, 98105, USA.
- Department of Medicine, University of Washington, 4225 Roosevelt Way NE, Seattle, WA, 98105, USA.
| | - Jared Egbert
- Department of Environmental and Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, Seattle, WA, 98105, USA
- Department of Preventive Medicine, Madigan Army Medical Center, Joint Base Lewis-McChord, Seattle, WA, USA
| | - Jennifer Krenz
- Department of Environmental and Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, Seattle, WA, 98105, USA
| | - Paul D Sampson
- Department of Statistics, University of Washington, Seattle, WA, USA
| | - Pablo Palmández
- Department of Environmental and Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, Seattle, WA, 98105, USA
| | - Elizabeth Torres
- Northwest Communities Education Center/Radio KDNA, Granger, WA, USA
| | - Maria Blancas
- Department of Environmental and Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, Seattle, WA, 98105, USA
| | - Jose Carmona
- Department of Environmental and Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, Seattle, WA, 98105, USA
| | - Jihoon Jung
- Department of Environmental and Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, Seattle, WA, 98105, USA
| | - John C Flunker
- Department of Environmental and Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, Seattle, WA, 98105, USA
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13
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Flunker JC, Zuidema C, Jung J, Kasner E, Cohen M, Seto E, Austin E, Spector JT. Potential Impacts of Different Occupational Outdoor Heat Exposure Thresholds among Washington State Crop and Construction Workers and Implications for Other Jurisdictions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11583. [PMID: 36141863 PMCID: PMC9517246 DOI: 10.3390/ijerph191811583] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 09/05/2022] [Accepted: 09/08/2022] [Indexed: 06/10/2023]
Abstract
Occupational heat exposure is associated with substantial morbidity and mortality among outdoor workers. We sought to descriptively evaluate spatiotemporal variability in heat threshold exceedances and describe potential impacts of these exposures for crop and construction workers. We also present general considerations for approaching heat policy-relevant analyses. We analyzed county-level 2011-2020 monthly employment (Bureau of Labor Statistics Quarterly Census of Employment and Wages) and environmental exposure (Parameter-elevation Relationships on Independent Slopes Model (PRISM)) data for Washington State (WA), USA, crop (North American Industry Classification System (NAICS) 111 and 1151) and construction (NAICS 23) sectors. Days exceeding maximum daily temperature thresholds, averaged per county, were linked with employment estimates to generate employment days of exceedances. We found spatiotemporal variability in WA temperature threshold exceedances and crop and construction employment. Maximum temperature exceedances peaked in July and August and were most numerous in Central WA counties. Counties with high employment and/or high numbers of threshold exceedance days, led by Yakima and King Counties, experienced the greatest total employment days of exceedances. Crop employment contributed to the largest proportion of total state-wide employment days of exceedances with Central WA counties experiencing the greatest potential workforce burden of exposure. Considerations from this analysis can help inform decision-making regarding thresholds, timing of provisions for heat rules, and tailoring of best practices in different industries and areas.
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Affiliation(s)
- John C. Flunker
- Department of Environmental and Occupational Health Sciences, Hans Rosling Center for Population Health, University of Washington, Seattle, WA 98195, USA
| | - Christopher Zuidema
- Department of Environmental and Occupational Health Sciences, Hans Rosling Center for Population Health, University of Washington, Seattle, WA 98195, USA
| | - Jihoon Jung
- Department of Environmental and Occupational Health Sciences, Hans Rosling Center for Population Health, University of Washington, Seattle, WA 98195, USA
| | - Edward Kasner
- Department of Environmental and Occupational Health Sciences, Hans Rosling Center for Population Health, University of Washington, Seattle, WA 98195, USA
| | - Martin Cohen
- Department of Environmental and Occupational Health Sciences, Hans Rosling Center for Population Health, University of Washington, Seattle, WA 98195, USA
| | - Edmund Seto
- Department of Environmental and Occupational Health Sciences, Hans Rosling Center for Population Health, University of Washington, Seattle, WA 98195, USA
| | - Elena Austin
- Department of Environmental and Occupational Health Sciences, Hans Rosling Center for Population Health, University of Washington, Seattle, WA 98195, USA
| | - June T. Spector
- Department of Environmental and Occupational Health Sciences, Hans Rosling Center for Population Health, University of Washington, Seattle, WA 98195, USA
- Safety & Health Assessment and Research for Prevention (SHARP) Program, Washington State Department of Labor and Industries, Olympia, WA 98504, USA
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14
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Berberian AG, Gonzalez DJX, Cushing LJ. Racial Disparities in Climate Change-Related Health Effects in the United States. Curr Environ Health Rep 2022; 9:451-464. [PMID: 35633370 PMCID: PMC9363288 DOI: 10.1007/s40572-022-00360-w] [Citation(s) in RCA: 59] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE OF REVIEW Climate change is causing warming over most parts of the USA and more extreme weather events. The health impacts of these changes are not experienced equally. We synthesize the recent evidence that climatic changes linked to global warming are having a disparate impact on the health of people of color, including children. RECENT FINDINGS Multiple studies of heat, extreme cold, hurricanes, flooding, and wildfires find evidence that people of color, including Black, Latinx, Native American, Pacific Islander, and Asian communities are at higher risk of climate-related health impacts than Whites, although this is not always the case. Studies of adults have found evidence of racial disparities related to climatic changes with respect to mortality, respiratory and cardiovascular disease, mental health, and heat-related illness. Children are particularly vulnerable to the health impacts of climate change, and infants and children of color have experienced adverse perinatal outcomes, occupational heat stress, and increases in emergency department visits associated with extreme weather. The evidence strongly suggests climate change is an environmental injustice that is likely to exacerbate existing racial disparities across a broad range of health outcomes.
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Affiliation(s)
- Alique G. Berberian
- Department of Environmental Health Sciences, University of California, 650 Charles E. Young Drive South, 71-259 CHS, Los Angeles, CA 90095 USA
| | - David J. X. Gonzalez
- School of Public Health and Department of Environmental Science, Policy, and Management, University of California, Berkeley, CA USA
| | - Lara J. Cushing
- Department of Environmental Health Sciences, University of California, 650 Charles E. Young Drive South, 71-259 CHS, Los Angeles, CA 90095 USA
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15
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Evoy R, Hystad P, Bae H, Kincl L. The impact of wildfire smoke and temperature on traumatic worker injury claims, Oregon 2009-2018. Health Sci Rep 2022; 5:e820. [PMID: 36177399 PMCID: PMC9476546 DOI: 10.1002/hsr2.820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 08/11/2022] [Accepted: 08/16/2022] [Indexed: 11/07/2022] Open
Abstract
Background and Aims As average temperatures rise and wildfire events increase in the United States, outdoor workers may be at an increased risk of injury. Recent research suggests that heat exposure increases outdoor workers' risk of traumatic injuries, but co-exposures of heat and wildfire smoke have not been evaluated. Methods Oregon workers' compensation data from 2009 to 2018 were linked to satellite data by the date of injury to determine if acute heat (maximum Heat Index) and wildfire smoke (presence/absence) were associated with a traumatic injury. North American Industry Classification System (NAICS) codes were utilized to identify accepted, disabling injury claims from construction (NAICS 23) and agriculture, forestry, fishing, and hunting (NAICS 11). Claims from April to October were analyzed using negative binomial models to calculate incident rate ratios (IRR) by heat and wildfire exposure for All workers and specifically for Agricultural (Ag)/Construction workers. Results During the study period, 91,895 accepted, traumatic injury claims were analyzed. All workers had an injury IRR of 1.04 (95% confidence interval [CI]: 1.02-1.06) while Ag/Construction workers had an IRR of 1.11 (95% CI: 1.06-1.16) when wildfire smoke was present. When the maximum Heat Index was 75°F or greater, the IRR significantly increased as temperatures increased. When the maximum Heat Index was above 80-84°F, All workers had an IRR of 1.04 (95% CI: 1.01-1.06) while Ag/construction workers had an IRR of 1.14 (95% CI: 1.08-1.21) with risk increasing with increased temperatures. In joint models, heat remained associated with injury rates, but not wildfire smoke. No multiplicative interactions between exposures were observed. Conclusion Increasing temperature was associated with increased rates of traumatic injury claims in Oregon that were more pronounced in Ag/Construction workers. Future work should focus on further understanding these associations and effective injury prevention strategies.
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Affiliation(s)
- Richard Evoy
- Environmental and Occupational Health Program, College of Public Health and Human SciencesOregon State UniversityCorvallisOregonUSA
| | - Perry Hystad
- Environmental and Occupational Health Program, College of Public Health and Human SciencesOregon State UniversityCorvallisOregonUSA
| | - Harold Bae
- Biostatistics Program, College of Public Health and Human SciencesOregon State UniversityCorvallisOregonUSA
| | - Laurel Kincl
- Environmental and Occupational Health Program, College of Public Health and Human SciencesOregon State UniversityCorvallisOregonUSA
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16
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Egbert J, Krenz J, Sampson PD, Jung J, Calkins M, Zhang K, Palmández P, Faestel P, Spector JT. Accuracy of an estimated core temperature algorithm for agricultural workers. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2022; 77:809-818. [PMID: 35114899 PMCID: PMC9346099 DOI: 10.1080/19338244.2022.2033672] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
There is a substantial burden of occupational health effects from heat exposure. We sought to assess the accuracy of estimated core body temperature (CBTest) derived from an algorithm that uses sequential heart rate and initializing CBT,1 compared with gastrointestinal temperature measured using more invasive ingestible sensors (CBTgi), among outdoor agricultural workers. We analyzed CBTest and CBTgi data from Washington State, USA, pear and apple harvesters collected across one work shift in 2015 (13,413 observations, 35 participants) using Bland Altman methods. The mean (standard deviation, range) CBTgi was 37.7 (0.4, 36.5-39.4)°C. Overall CBT bias (limits of agreement) was -0.14 (±0.76)°C. Biases ranged from -0.006 to -0.75 °C. The algorithm, which does not require the use of ingestible sensors, may be a practical tool in research among groups of workers for evaluating the effectiveness of interventions to prevent adverse occupational heat health effects.
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Affiliation(s)
- Jared Egbert
- Department of Preventive Medicine, Madigan Army Medical Center, Joint Base Lewis-McChord, WA, USA
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Jennifer Krenz
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Paul D. Sampson
- Department of Statistics, University of Washington, Seattle, WA, USA
| | - Jihoon Jung
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Miriam Calkins
- Division of Field Studies and Engineering - Field Research Branch, National Institute for Occupational Safety & Health, Centers for Disease Control and Prevention, Cincinnati, OH, USA
| | - Kai Zhang
- Department of Environmental Health Sciences, University of Albany, State University of New York, Albany, NY, USA
| | - Pablo Palmández
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Paul Faestel
- Department of Preventive Medicine, Madigan Army Medical Center, Joint Base Lewis-McChord, WA, USA
| | - June T. Spector
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
- Department of Medicine, University of Washington, Seattle, WA, USA
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17
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Increased labor losses and decreased adaptation potential in a warmer world. Nat Commun 2021; 12:7286. [PMID: 34907184 PMCID: PMC8671389 DOI: 10.1038/s41467-021-27328-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 11/08/2021] [Indexed: 02/06/2023] Open
Abstract
Working in hot and potentially humid conditions creates health and well-being risks that will increase as the planet warms. It has been proposed that workers could adapt to increasing temperatures by moving labor from midday to cooler hours. Here, we use reanalysis data to show that in the current climate approximately 30% of global heavy labor losses in the workday could be recovered by moving labor from the hottest hours of the day. However, we show that this particular workshift adaptation potential is lost at a rate of about 2% per degree of global warming as early morning heat exposure rises to unsafe levels for continuous work, with worker productivity losses accelerating under higher warming levels. These findings emphasize the importance of finding alternative adaptation mechanisms to keep workers safe, as well as the importance of limiting global warming. Outdoor workers may need to adapt to warming by moving labor from midday to cooler hours. Here the authors find this adaptation strategy loses efficacy under additional climate change due to increased heat exposure in the coolest hours of the day.
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Sartin EB, Metzger KB, Pfeiffer MR, Myers RK, Curry AE. Facilitating research on racial and ethnic disparities and inequities in transportation: Application and evaluation of the Bayesian Improved Surname Geocoding (BISG) algorithm. TRAFFIC INJURY PREVENTION 2021; 22:S32-S37. [PMID: 34402327 PMCID: PMC8792156 DOI: 10.1080/15389588.2021.1955109] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 07/07/2021] [Accepted: 07/08/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Racial and ethnic disparities and/or inequities have been documented in traffic safety research. However, race/ethnicity data are often not captured in population-level traffic safety databases, limiting the field's ability to comprehensively study racial/ethnic differences in transportation outcomes, as well as our ability to mitigate them. To overcome this limitation, we explored the utility of estimating race and ethnicity for drivers in the New Jersey Safety and Health Outcomes (NJ-SHO) data warehouse using the Bayesian Improved Surname Geocoding (BISG) algorithm. In addition, we summarize important recommendations established to guide researchers developing and implementing racial and ethnic disparity research. METHODS We applied BISG to estimate population-level race/ethnicity for New Jersey drivers in 2017 and evaluated the concordance between reported values available in integrated administrative sources (e.g., hospital records) and BISG probability distributions using an area under the receiver operator curve (AUC) within each race/ethnicity category. Overall AUC was calculated by weighting each AUC value by the population count in each reported category. In an exemplar analysis using 2017 crash data, we conducted an analysis of average monthly police-reported crash rates in 2017 by race/ethnicity using the NJ-SHO and BISG sets of race/ethnicity values to compare their outputs. RESULTS We found excellent or outstanding concordance (AUC ≥0.86) between reported race/ethnicity and BISG probabilities for White, Hispanic, Black, and Asian/Pacific Islander drivers. We found poor concordance for American Indian/Alaskan Native drivers (AUC= 0.65), and concordance was no better than random assignment for Multiracial drivers (AUC = 0.52). Among White, Hispanic, Asian/Pacific Islander, and American Indian/Alaskan native drivers, monthly crash rates calculated using both NJ-SHO reported race/ethnicity values and BISG probabilities were similar. Monthly crash rates differed by 11% for Black drivers, and by more than 200% for Multiracial drivers. CONCLUSION Findings of excellent or outstanding concordance between and mostly similar crash rates derived from reported race/ethnicity and BISG probabilities for White, Hispanic, Black, and Asian/Pacific Islander drivers (98.9% of all drivers in this sample) demonstrate the potential utility of BISG in enabling research on transportation disparities and inequities. Concordance between race/ethnicity values were not acceptable for American Indian/Alaskan Native and Multiracial drivers, which is similar to previous applications and evaluations of BISG. Future work is needed to determine the extent to which BISG may be applied to traffic safety contexts.
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Affiliation(s)
- Emma B. Sartin
- Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Kristina B. Metzger
- Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Melissa R. Pfeiffer
- Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Rachel K. Myers
- Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, PA
- Division of Emergency Medicine, Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Allison E. Curry
- Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, PA
- Division of Emergency Medicine, Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
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19
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Krenz J, Santos EC, Torres E, Palmández P, Carmona J, Blancas M, Marquez D, Sampson P, Spector JT. The multi-level heat education and awareness tools [HEAT] intervention study for farmworkers: Rationale and methods. Contemp Clin Trials Commun 2021; 22:100795. [PMID: 34169175 PMCID: PMC8209069 DOI: 10.1016/j.conctc.2021.100795] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 05/24/2021] [Accepted: 06/03/2021] [Indexed: 11/29/2022] Open
Abstract
Background The burden of adverse health effects from heat exposure is substantial, and outdoor workers who perform heavy physical work are at high risk. Though heat prevention interventions have been developed, studies have not yet systematically evaluated the effectiveness of approaches that address risk factors at multiple levels. Objective We sought to test the effectiveness of a multi-level heat prevention approach (heat education and awareness tools [HEAT]), which includes participatory training for outdoor agricultural workers that addresses individual and community factors and a heat awareness mobile application for agricultural supervisors that supports decisions about workplace heat prevention, in the Northwest United States. Design We designed the HEAT study as a parallel, comparison, randomized group intervention study that recruited workers and supervisors from agricultural workplaces. In intervention arm crews, workers received HEAT training, and supervisors received the HEAT awareness application. In comparison arm crews, workers were offered non-HEAT training. Primary outcomes were worker physiological heat strain and heat-related illness (HRI) symptoms. In both worker groups, we assessed HRI symptoms approximately weekly, and heat strain physiological monitoring was conducted at worksites approximately monthly, from June through August. Discussion To our knowledge, this is the first study to evaluate the effectiveness of a multi-level heat prevention intervention on physiological heat strain and HRI symptoms for outdoor agricultural workers. Trial registration ClinicalTrials.gov Registration Number: NCT04234802;
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Affiliation(s)
- Jennifer Krenz
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | | | - Elizabeth Torres
- Northwest Communities Education Center/Radio KDNA, Granger, WA, USA
| | - Pablo Palmández
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Jose Carmona
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Maria Blancas
- College of the Environment, University of Washington, Seattle, WA, USA
| | - Diana Marquez
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Paul Sampson
- Department of Statistics, University of Washington, Seattle, WA, USA
| | - June T Spector
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA.,Department of Medicine, University of Washington, Seattle, WA, USA
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Pedersen KM, Busch Isaksen TM, Baker MG, Seixas N, Errett NA. Climate Change Impacts and Workforce Development Needs in Federal Region X: A Qualitative Study of Occupational Health and Safety Professionals' Perceptions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041513. [PMID: 33562700 PMCID: PMC7915234 DOI: 10.3390/ijerph18041513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 01/29/2021] [Accepted: 02/01/2021] [Indexed: 11/16/2022]
Abstract
Climate change is considered one of the top health threats in the United States. This research sought to (1) to understand the perceptions of occupational health and safety (OHS) professionals regarding the impacts of climate-related hazards on OHS in Region X, and (2) to explore the ideas of these OHS professionals regarding the content of future training programs that would better prepare OHS professionals to identify and mitigate climate-related hazards in Region X. Key informant (KI) interviews with 17 OHS professionals familiar with the climate-related hazards and impacts to OHS in Region X were coded and thematically analyzed. Climate hazards, social and economic impacts from climate-related hazards, and sector-specific worker and workplace impacts from climate-related hazards were described as having interacting relationships that influenced worker health and safety impacts. KIs further described how workplace controls could be used to mitigate OHS impacts of climate-related hazards, and how training of the OHS workforce could influence the ability to successfully implement such controls. Our findings suggest that OHS impacts are sector-specific, influenced by social and economic factors, and can be mitigated through workplace controls designed and implemented by a trained OHS workforce. The findings from this work should inform future educational and training programming and additional research and translation activities in the region, while our approach can inform other regions as they develop regionally specific OHS climate change training and programming.
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Affiliation(s)
- Katherine M. Pedersen
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA 98105, USA; (K.M.P); (T.M.B.I.); (M.G.B.); (N.S.)
- Department of Health Services, School of Public Health, University of Washington, Seattle, WA 98195, USA
- Department of Urban Design and Planning, College of Built Environments, University of Washington, Seattle, WA 98195, USA
| | - Tania M. Busch Isaksen
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA 98105, USA; (K.M.P); (T.M.B.I.); (M.G.B.); (N.S.)
| | - Marissa G. Baker
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA 98105, USA; (K.M.P); (T.M.B.I.); (M.G.B.); (N.S.)
| | - Noah Seixas
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA 98105, USA; (K.M.P); (T.M.B.I.); (M.G.B.); (N.S.)
| | - Nicole A. Errett
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA 98105, USA; (K.M.P); (T.M.B.I.); (M.G.B.); (N.S.)
- Department of Health Services, School of Public Health, University of Washington, Seattle, WA 98195, USA
- Correspondence:
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Heinzerling A, Laws RL, Frederick M, Jackson R, Windham G, Materna B, Harrison R. Risk factors for occupational heat-related illness among California workers, 2000-2017. Am J Ind Med 2020; 63:1145-1154. [PMID: 33075156 DOI: 10.1002/ajim.23191] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 08/27/2020] [Accepted: 09/21/2020] [Indexed: 11/11/2022]
Abstract
BACKGROUND As climate change increases global temperatures, heat-related morbidity and mortality are projected to rise. Outdoor workers and those who perform exertional tasks are particularly susceptible to heat-related illness (HRI). Using workers' compensation data, we aimed to describe rates of occupational HRI in California and identify demographic and occupational risk factors to inform prevention efforts. METHODS We identified HRI cases during 2000-2017 in the California Workers' Compensation Information System (WCIS) using International Classification of Diseases Ninth and Tenth Revision codes, WCIS nature and cause of injury codes, and HRI keywords. We assigned industry and occupation codes using the NIOSH Industry and Occupation Computerized Coding System (NIOCCS). We calculated HRI rates by sex, age group, year, county, industry, and occupation, and estimated confidence intervals using generalized linear models. RESULTS We identified 15,996 HRI cases during 2000-2017 (6.0 cases/100,000 workers). Workers aged 16-24 years had the highest HRI rate (7.6) among age groups, and men (8.1) had a higher rate than women (3.5). Industry sectors with the highest HRI rates were Agriculture, Farming, Fishing, and Forestry (38.6), and Public Administration (35.3). Occupational groups with the highest HRI rates were Protective Services (56.6) and Farming, Fishing, and Forestry (36.6). Firefighters had the highest HRI rate (389.6) among individual occupations. CONCLUSIONS Workers in certain demographic and occupational groups are particularly susceptible to HRI. Additional prevention efforts, including outreach and enforcement targeting high-risk groups, are needed to reduce occupational HRI. Workers' compensation data can provide timely information about temporal trends and risk factors for HRI.
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Affiliation(s)
- Amy Heinzerling
- California Department of Public Health, Center for Healthy Communities, Richmond, California, USA
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Rebecca L Laws
- California Department of Public Health, Center for Healthy Communities, Richmond, California, USA
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Matt Frederick
- California Department of Public Health, Center for Healthy Communities, Richmond, California, USA
- Public Health Institute, Oakland, California, USA
| | - Rebecca Jackson
- California Department of Public Health, Center for Healthy Communities, Richmond, California, USA
| | - Gayle Windham
- California Department of Public Health, Center for Healthy Communities, Richmond, California, USA
| | - Barbara Materna
- California Department of Public Health, Center for Healthy Communities, Richmond, California, USA
| | - Robert Harrison
- California Department of Public Health, Center for Healthy Communities, Richmond, California, USA
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