Distribution of lost-work-time claims for skin disease in California agriculture: 1978-1983

Treating skin disease: self-management behaviors of Latino farmworkers

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.

Skin symptoms and work-related skin symptoms among grape farmers in Crete, Greece

BACKGROUND

Grape farmers are exposed to a variety of agents capable of inducing occupational skin disease. We conducted a study to measure the prevalence of skin symptoms and work-related skin symptoms among grape farmers in the Malevisi region of Crete and to provide data on associated risk factors.

METHODS

One hundred twenty grape farmers and 100 controls participated in the study. The protocol consisted of a questionnaire, skin prick tests for 16 common allergens, and measurement of specific IgE antibodies against 8 allergens.

RESULTS

Self-reported itchy rash (OR, 2.31; 95%CI, 1.10-4.84, P<0.05) within the last 12 months, and work-related itchy rash (OR, 4.08; 95%CI, 1.01-20.33, P<0.05) were significantly higher in grape farmers than in controls, after adjusting for age and sex. Sensitization to pollens (OR, 4.20; 95% CI, 1.41-12.82, P<0.01) and allergic rhinitis (OR, 3.06; 95% CI, 1.21-8.28, P<0.05) were found to be significantly associated with self-reported itchy rash in the grape farmers group.

CONCLUSIONS

Grape farmers reported skin symptoms more frequently than non-exposed controls, and IgE-mediated sensitization to pollens was found to be significantly associated with the reported symptoms. Further studies are needed to evaluate the impact of specific occupational agents on skin diseases among grape farmers.

Self-reported dermatitis and skin cancer in California farm operators

BACKGROUND

High rates of skin diseases and higher non-melanoma skin cancer rates have been reported in farmers.

METHODS

Self-report of dermatitis and skin cancer was among the information collected from 1947 California farm operators, mostly men, in a telephone survey. The majority of the farmers cultivated fruits, nuts, or other field crops.

RESULTS

Dermatitis was reported by 8.9% of men and 15.8% of women during the previous 12 months. In a logistic regression model, female gender (OR 2.0, 95% confidence interval 1.3-3.0) and respiratory atopy (OR 1.4, 1.01-1.90) were the only significant independent risk factors for reported dermatosis. There was significantly less reporting of skin cancer among field farmers when compared to others. Regular sunscreen use was reported significantly more often by women (42%) as compared to men (11%).

CONCLUSIONS

More in-depth studies are needed to get information on the role of agrochemicals as risk factors for dermatitis and skin cancer.

Occupational dermatoses among Polish private farmers, 1991-1999

BACKGROUND

Little is known about work-related skin diseases among Polish self-employed farmers. In the National Register of Occupational Diseases, private farmers are placed in one category together with other agricultural workers, despite fundamental differences in compensation legislation and separate insurance institutions. The Agricultural Social Insurance Fund reports only on numbers of compensated cases. The aim of this study was to create reliable statistics on occupational dermatoses among private farmers.

METHODS

All cases of work-related skin diseases diagnosed from 1991 to 1999 were included in the statistics. Compensation records of the Agricultural Social Insurance Fund were analyzed for diagnoses, causative factors, and health impairment of the skin.

RESULTS

The first occupational dermatosis was registered in 1992. Until the end of 1999, there were 101 cases (63 women and 38 men). The incidence rose from 0.006/10000/year in 1992 to 0.189/10000/year in 1999. Allergic contact dermatitis was the most common diagnosis (86%), followed by infectious skin diseases (10%), irritant contact dermatitis (3%), and urticaria (2%). The most frequently identified causative factors were plant dusts (38%), animal allergens (36%), metals (29%), pesticides (18%), and rubber chemicals (15%). The median impairment due to skin disease was 20% (range 2-36%).

CONCLUSIONS

Since the introduction of workers' compensation, the numbers of occupational dermatoses diagnosed in Polish private farmers have increased rapidly. However, compared to countries with a longer experience in this field, these figures remain low, probably due to low detection of these diseases.

Occupational dermatitis in Danish gardeners and greenhouse workers (I). Prevalence and possible risk factors

Floristry is considered a hazardous occupation from a dermatological point of view, but there are relatively few epidemiological studies to support this notion. The present investigation set out to assess the prevalence of and association between occupational dermatitis and possible risk factors in Danish gardeners and greenhouse workers. A cross-sectional study, based on a postal questionnaire and subsequent examination and patch testing of those who had occupational eczema from their present work or occupational problems with Compositae, was carried out in 1958 gardeners and greenhouse workers. The response rate was 84.6% and among 301 persons invited for further examination, 253 (84.1%) attended. The lifetime prevalence of occupational eczema in floristry, defined as dermatitis lasting more than 24 h, was 19.6% (95% confidence intervals 17.8-21.3%) among all potential respondents. Occupational mucosal symptoms, working with Compositae plants and a history of previous occupational eczema in floristry were significantly associated with an increased risk of occupational eczema. Sex, age and atopy did not seem to be important risk factors. The results confirm that floristry is a dermatologically hazardous occupation and emphasize the importance of eliciting agents in the working environment rather than personal inherent factors.

Determinants of disability in illnesses related to agricultural use of organophosphates (OPs) in California

Organophosphate (OP)-related illness data reported to the Worker Health and Safety Branch (WH&S) at the California Department of Food and Agriculture (CDFA, now Cal-EPA) in the years 1984-1988 were examined. Eight hundred and seventy-eight cases with systemic illness and 199 cases of skin disease or eye injury were identified. Systemic cases were divided into two outcome groups: (1) "severe," disability and/or hospitalization days (n = 361), and (2) "mild," no disability or hospitalization days (n = 372). For the remainder (n = 145) or 16.5% of the cases, illness severity could not be determined. Using multiple logistic regression, independent predictors of "severe" illness were identified among the systemic cases. Workers coming in contact with OP residue on commodities or in the field ("exposed to residue" or ER) (OR = 4.6, 95% CI = 3.03-7.07) and mixer/loaders/applicators (MLA) (OR = 4.1, 95% CI = 2.72-6.07) were at significantly increased risk of severe illness when compared with cases exposed to OP application drift. Cases with a Spanish surname were also at increased risk of severe illness (OR = 1.8, 95% CI = 1.25-2.73). Increased numbers of OPs per exposure were also associated with severe illness (p < 0.001). Among cases who were exposed to only one OP, severe systemic cases were more likely than mild systemic cases to be associated with exposure to diethyl than dimethyl compounds (OR = 1.6, 95% CI = 1.09-2.38). Severe systemic cases were also more likely than severe skin/eye cases to be associated with exposure to OPs with high toxicity (OR = 5.5, 95% CI = 2.42-12.60) and with exposure to diethyl groups (OR = 4.8, 95% CI = 1.90-12.00). These findings suggest that reducing exposure to OP residues, to OPs with diethyl groups, and to multiple OPs, and exposure during mixer/loader/applicator activities would reduce the risk of OP-related illness.

Hand eczema in Finnish farmers. A questionnaire-based clinical study

In a population of 2005 Finnish farmers, 172 (8.6%) reported hand or forearm dermatoses in a self-administered questionnaire. 138 (80%) of them attended a clinical examination. Skin prick tests (SPTs) were done to 80% and patch tests (PTs) to 77% of the examined farmers. 93% of hand dermatoses were eczema and 70% were considered work-related. Cow allergy was found in 41 of 104 prick- and patch-tested farmers (39%). Immediate allergy to cow epithelium was encountered in a total of 28/41, in 20 with SPTs, and in 8 only with 20 min PTs. Delayed contact allergy to cow dander was found in 27/41. The result suggests that in addition to SPTs using commercial cow epithelium extract, PTs using fresh cow dander should also be done, and both immediate and delayed responses should be read.

Occupational injuries and illnesses among Washington State agricultural workers

In Washington state 29,451 workers' compensation claims were filed by farm workers between 1982 and 1986. Five percent of claimants were under 18 years of age, including 1.3% under the age of 16. Agricultural workers were found to be at higher risk than other workers in the state for fatal injury (relative risk [RR] = 2.5, 95% confidence interval [CI] = 1.7-3.7), sprains and strains (RR = 1.4, CI = 1.3-1.4), fractures (RR = 2.3, CI = 2.2-2.4), dislocations (RR = 1.9, CI = 1.7-2.2), concussions (RR = 1.9, CI = 1.6-2.3), amputations (RR = 2.5, CI = 2.0-3.1), dermatitis (RR = 4.3, CI = 4.0-4.7), systemic poisoning (RR = 3.4, CI = 3.1-3.7), respiratory disease (RR = 1.7, CI = 1.0-2.9), and tendonitis (RR = 1.2, CI = 1.1-1.4).

The relationship between work-related and non-work-related injuries

A case-control study of occupational injuries sustained by 914 male hourly workers employed in two Tenneco manufacturing divisions in 1987 was undertaken to examine the association between occupational and non-occupational injuries. Its aim was to evaluate whether employees who experienced a work-related injury were more likely to have sustained a previous non-work-related injury compared to individuals who did not experience a work-related injury. A statistically significant association between occupational injuries and past non-occupational injuries was seen when all workers compensation (WC) claims were analyzed (OR = 1.41) and when claims involving indemnity for lost time were analyzed (OR = 1.82). In addition, both workers who had occupational low-back injuries and workers who had occupational non-low-back injuries also had significantly higher risks of such injuries from a non-occupational origin (OR = 1.91 for low-back injuries and OR = 1.44 for non-low-back injuries). The findings suggest that elements other than workplace hazards (such as life-style and physical and psychological factors) may predispose an individual to both occupational and non-occupational injuries.