Musculoskeletal Injury, Functional Disability, and Health-Related Quality of Life in Aging Mexican Immigrant Farmworkers

"Death by a Thousand Cuts": Agriculture Producer Resiliency in the Western United States

OBJECTIVE

Agricultural producers face a wide array of stress triggers, shocks, and long-term pressures such as drought, flooding, fire, government policies, financial insecurity, and physical injuries. Extant research has revealed that mental health stigma, lack of access to care in rural areas, and negative coping responses (alcohol abuse, suicide, prescription drugs use) exacerbate the challenge of producer responses to short and long-term adversity. Resilience, the traits, processes, and capacities of producers to adapt and transform their approach to farming or ranching, when necessary, in response to stress triggers or long-term pressures, has received less research attention, particularly in the Western United States. The purpose of the study was to apply an interactionist occupational resilience theoretical perspective to the investigation of contextual factors contributing to resilience in Western United States agricultural producers.

METHODS

Qualitative interviews (45 to 90 minutes) were conducted with agricultural producers (n=51) from Western states and territories. Applied thematic analysis with a phenomenological lens was utilized to analyze interview transcriptions. First and second level coding were conducted to derive themes.

RESULTS

The analysis revealed that resilience is based upon the interactions between traits of producers and the context of agriculture. Four themes were generated (Agricultural Life, External Stressors, Traits and Adaptations, and Supports and Resources), supported by subthemes. The themes and subthemes are depicted in an agricultural producer resiliency model. The findings shed light on the equivocal role of neighbors in providing support for each other and the double-edged sword of co-working with family.

CONCLUSIONS

The findings underscore that social capital is an important mechanism for supporting farmers and ranchers, as those with stronger social resources are more resilient. We recommend more funding to tailor stress and mental health programming to the specifics of agriculture, integration of behavioral health in primary care as a mechanism to increase access to care, and more intentional technical assistance for farmers and ranchers on strategic planning and problem solving.

Translation and Validation of the Risk Perception on Safety and Health Questionnaire Among Palm Oil Plantation Workers in Terengganu, Malaysia

INTRODUCTION

Occupational safety and health are of utmost importance in the palm oil industry, particularly in Malaysia where palm oil plantation workers face various hazards. This study aimed to translate and validate a risk perception questionnaire specifically designed to assess the perceptions of safety and health risks among palm oil plantation workers in Terengganu, Malaysia.

METHODOLOGY

The original risk perception questionnaire, consisting of 22 items, was translated into the local language and culturally adapted. The translation process involved forward translation, expert panel discussions, and back translation to ensure linguistic equivalence. The translated questionnaire was then administered to a sample of palm oil plantation workers in Terengganu, Malaysia, for validation purposes. Confirmatory factor analysis (CFA) was conducted to assess the model fitness of the questionnaire, and Cronbach's Alpha coefficient was calculated to determine the internal consistency reliability of the final model.

RESULTS

The translated risk perception questionnaire demonstrated good model fitness as indicated by CFA results (X2=224, df=79, p-value<0.0001, root mean square error of approximation (RMSEA)=0.07, goodness of fit index (GFI)=0.929, comparative fit index (CFI)=0.902). The questionnaire's final version has one factor comprising 13 items, selected based on factor loadings and theoretical relevance. The internal consistency reliability of the 13-item questionnaire was satisfactory, with a Cronbach's Alpha coefficient of α=0.77.

CONCLUSION

The 13-item risk perception questionnaire demonstrated a good model fit and acceptable internal consistency reliability. It shows that the questionnaire is a valid and reliable tool to evaluate the level of risk perception on safety and health among palm oil plantation workers in Malaysia.

Examining associations between work-related injuries and all-cause healthcare use among middle-aged and older workers in Canada using CLSA data

INTRODUCTION

Prior studies examining the relationship between work- related injuries and healthcare use among middle-aged and older workers were mainly cross-sectional and reported inconsistent results.

OBJECTIVE

The objective of this study was to examine the associations between work-related injuries and 10 types of healthcare service use for any cause among middle-aged and older Canadian workers using longitudinal data.

METHODS

Our study involved longitudinal analysis of baseline and 18-month follow-up Maintaining Contact Questionnaire data from the Canadian Longitudinal Survey on Aging (CLSA) for a national sample of Canadian males and females aged 45-85 years who worked or were recently retired (N = 24,748).

RESULTS

Among CLSA participants who worked or were recently retired, 361 per 10,000 reported a work-related injury within the year prior to the survey. Work-related injuries decreased with increasing age. Work-related injury was associated with emergency department visits, overnight hospitalization, visits to dentists, and visits to physiotherapists, occupational therapists, or chiropractors at follow-up in bivariate analyses. Compared to those with no work-related injuries, Canadians with work-related injuries had used, on average, a significantly higher number of health services within the last 12 months prior their survey. When controlling for the contribution of various socio-demographic, work-related, and health-related characteristics, work-related injuries remained a significant predictor of emergency department visits and visits to physiotherapists, occupational therapists, or chiropractors.

CONCLUSIONS

The relationship between work-related injuries, emergency department visits, and visits to physiotherapists, occupational therapists, or chiropractors in middle-aged and older workers in Canada suggests that workplace injuries can be associated with ongoing health problems.

PRACTICAL APPLICATIONS

Healthcare services used by injured employees must be considered priorities for employment insurance coverage, if not already covered. Future research should more fully examine whether pre-existing health conditions predict both work-related injury and subsequent health problems. Injury-specific healthcare use following work-related injuries in middle-aged and older workers, as well as economic costs, should also be examined.

Characterization of Lifetime Agrichemical Exposure Sequences Relative to International Migration in Foreign Born Latinx Agricultural Workers Living in South Florida

There is a limited understanding of how toxic exposures to agrichemicals vary relative to international migration over the life course. A life history calendar (LHC) was piloted to explore sequences of agrichemical exposure relative to international migration. LHCs were administered to 41 foreign born individuals from Mexico and Central America who had agricultural work experience during their lifetime and who were living in South Florida. Social sequence analysis was used to explore occupation-by-agrichemical events relative to migration. A three-cluster solution was used to classify low, moderate, and high lifetime exposure sequences. The odds of any perceived effects of agrichemicals on the body increased with time prior to migration in the moderate and high exposure sequence clusters and continued to increase 20% with each year following migration in the moderate exposure cluster. Workers with high lifetime agrichemical exposures prior to migrating internationally showed lower likelihoods of a perceived effect on the body following migration despite continued exposure. Further research on instrument validity is warranted.

Socio-Demography, Working Conditions, and Musculoskeletal Ailments among Pineapple Farmers in Northeast India

This study was conducted to examine the socio-demography, working conditions, and consequential musculoskeletal ailments of pineapple farmers in northeast India. A total of 152 pineapple farmers (92 males and 60 females) participated in the study. Data were collected using a pre-tested structured schedule and a standard Nordic questionnaire through personal interviews followed by direct observation. Chi-square (χ²) analysis and multiple logistic regression were conducted using SPSS software 16.0 to explore the association of various independent factors and their influences on the musculoskeletal symptoms (MSS) scores. The study revealed that a majority (>85%) of the pineapple farmers in northeast India had low to medium annual income, with more than 95% of the farmers belonging to small and marginal categories. Moreover, MSS were highly prevalent among the farmers (79.61%), and the low-back (76.32%) was the most affected body part. The results of the Chi-square (χ²) analysis highlighted that age, education level, and farming experience were significantly associated (p < 0.05) with the prevalence of overall MSS among the pineapple farmers. Among the factors, only age and gender significantly influenced the risk of complaints for the farmers' neck (OR = 6.62, 95% CI: 1.29-34.02, p ≤ 0.05) and low back (OR = 2.54, 95% CI: 1.00-6.47, p ≤ 0.05). This study's findings demonstrated the need for the urgent exploration of sustainable and innovative interventions to reduce the occurrence of MSS and improve the working conditions of the pineapple farmers in northeast India.

A Cross-sectional Study of Gender-related Differences in Reporting Fatigue and Pain among Latino/A Migrant Farmworkers

Objectives: Migrant farmworkers face many hardships in both their working and living environments including dangerous and demanding tasks, long hours, and inadequate rest. This study sought to explore gender differences in the reporting of fatigue and pain and to identify predictors of fatigue and pain among migrant farmworkers in Nebraska (n = 241). Methods: Bivariate tests were used to assess associations among study variables. Linear and generalized linear mixed effect models were used to assess gender as a predictor of fatigue and pain respectively while controlling for covariates. Results: Females reported significantly higher levels of fatigue (M score = 15.5, SD = 6.1 compared to M score = 12.8, SD = 4.3) than their male counterparts. Females were also more likely to report pain (56.9% of females compared to 36.3% of males). Being female, pain, hours of sleep, and job demands were significant predictors of fatigue. Fatigue and job-related injury were the only significant predictors of pain. Conclusions: There are gender-related disparities in the reporting of fatigue and pain among Latino/a migrant farmworkers. Extra precautions need to be taken to protect worker health and safety and reduce fatigue, particularly for female workers. Implications for employers, supervisors, and healthcare providers are discussed.

Assessing Health and Safety Concerns and Psychological Stressors among Agricultural Workers in the U.S. Midwest

There is limited research exploring agricultural workers' own perspectives on the relative importance of the hazards and stressors they experience. There is also a lack of evidence on whether this reporting differs by method of elicitation. Finally, very little research exists on how to improve mail survey response rates among agricultural workers. We examined health and safety concerns and psychological stressors among Midwestern farmers. We assessed whether these reports varied by survey mode (mail survey versus in-person survey). The efficacy of two different types of incentives to enhance mail survey response rates among agricultural workers was also investigated. In 2018, a needs assessment survey was developed and mailed to a random sample of farm owner-operators in Iowa, Ohio, and Missouri, with randomly assigned prepaid or promised monetary incentives. In-person surveys were conducted among farm owner-operators and hired workers at three regional farm shows in Iowa, Minnesota, and Nebraska. The mail survey response rates were compared by incentive type. Content analysis was used to generate themes associated with health and safety concerns and psychological stressors, which were then ranked by frequency counts. Chi-square tests were used to analyze variation in the distribution of these themes by survey mode. The response rate for the $1 prepaid incentive was double that of the $10 promised incentive. Content analysis identified 13 health and safety concerns and eight psychological stressors. Chemicals, equipment/tools, and health outcomes were the most frequently noted health and safety concerns. Finances, climate/weather, and farm workload and management were the most frequently noted psychological stressors. Although there was considerable overlap in survey responses across mail and in-person respondents, important differences by sample and survey mode characteristics were observed. The results can support a variety of stakeholders in prioritizing and developing interventions and educational resources to address health and safety concerns and psychological stressors among Midwestern farmers. Our findings also contribute to the evidence base on primary data collection methods for agricultural workers.

Migrants and disability following injury: findings from a prospective study in New Zealand

OBJECTIVES

To compare the prevalence of disability between migrants and non-migrants at three and 24 months post-injury, and to identify key predictors of post-injury disability among migrants.

METHODS

Disability among 2,850 injured participants, including 677 migrants to New Zealand, was measured prospectively using the World Health Organization Disability Assessment Schedule.

RESULTS

Migrants experienced higher risk of disability than non-migrants at three months post-injury (aRR=1.14, 95%CI 1.03-1.26). Both groups had similar disability prevalence, but higher than pre-injury, at 24 months. For migrants, strong predictors of disability at three months post-injury were: higher injury severity, pre-injury obesity, and perceiving the injury as a threat of disability. Having multiple chronic conditions was a predictor of disability at both time points.

CONCLUSIONS

Disability was persistent for migrants and non-migrants to 24 months post-injury. The disability risk at three months was higher for migrants. Certain predictors associated with disability were identified. Implications for public health: Despite having accessed healthcare services for their injury, migrants (compared with non-migrants) had higher risks of disability at least in the first three months post-injury. Interventions should be focused during this critical period on identified key predictors to promote faster recovery and reduce disability.

Discourse on culture in research on immigrant and migrant workers' health

BACKGROUND

Health and safety researchers and practitioners have proposed that cultural differences help explain inequalities between foreign and native-born workers. While cultural explanations for inequalities have long been debated in other fields, there exists little critique of cultural discourses in occupational health.

METHODS

This article examines and discusses the discourse on culture in 107 articles on immigrant or migrant workers' health published between 2011 and 2015. For each article, passages on culture were identified and analysed for both the context and the manner in which culture was discussed.

RESULTS

The discourse on culture was found to be generally simplistic, individualistic, and uncritical, intentionally or unintentionally supporting the worldview that workers' "otherness" is both cause of inequalities and target for interventions.

CONCLUSION

The article argues that empirical, theoretical and interdisciplinary work is needed to document the mechanisms and pathways that underlie health and safety inequalities by foreign-born status.

Medical Pluralism in the Use of Sobadores among Mexican Immigrants to North Carolina

Mexican immigrants have a rich history of traditional healers. This analysis describes the conditions for which Mexican immigrants seek treatment from sobadores, and delineates factors that influence seeking treatment from a sobador or a biomedical doctor. This systematic qualitative analysis uses interview data collected with 24 adult Mexican immigrants to North Carolina who had been treated by a sobador in the previous 2 years. Immigrants are engaged in medical pluralism, seeking care from sobadores and biomedical doctors based on the complaint and patient's age. Using a hierarchy of resort, adults seek treatment from sobadores for musculoskeletal pain not involving a fracture. Doctors are first consulted when treating children; sobadores are consulted if doctors do not provide culturally appropriate treatment. Mexican immigrants seek care that addresses their culturally determined health concerns. The need to improve access to culturally competent biomedical health care for vulnerable immigrant populations continues.

A Novel Method for Repeatable Failure Testing of Annulus Fibrosus

Tears in the annulus fibrosus (AF) of the intervertebral disk can result in disk herniation and progressive degeneration. Understanding AF failure mechanics is important as research moves toward developing biological repair strategies for herniated disks. Unfortunately, failure mechanics of fiber-reinforced tissues, particularly tissues with fibers oriented off-axis from the applied load, is not well understood, partly due to the high variability in reported mechanical properties and a lack of standard techniques ensuring repeatable failure behavior. Therefore, the objective of this study was to investigate the effectiveness of midlength (ML) notch geometries in producing repeatable and consistent tissue failure within the gauge region of AF mechanical test specimens. Finite element models (FEMs) representing several notch geometries were created to predict the location of bulk tissue failure using a local strain-based criterion. FEM results were validated by experimentally testing a subset of the modeled specimen geometries. Mechanical testing data agreed with model predictions (∼90% agreement), validating the model's predictive power. Two of the modified dog-bone geometries (“half” and “quarter”) effectively ensured tissue failure at the ML for specimens oriented along the circumferential-radial and circumferential-axial directions. The variance of measured mechanical properties was significantly lower for notched samples that failed at the ML, suggesting that ML notch geometries result in more consistent and reliable data. In addition, the approach developed in this study provides a framework for evaluating failure properties of other fiber-reinforced tissues, such as tendons and meniscus.

Acute joint pain in the emerging green collar workforce: Evidence from the linked National Health Interview Survey and Occupational Information Network (O*NET)

BACKGROUND

Green jobs are a rapidly emerging category of very heterogeneous occupations that typically involve engagement with new technologies and changing job demands predisposing them to physical stressors that may contribute to the development of joint pain.

METHODS

We estimated and compared the prevalence of self-reported acute (past 30 days) joint pain between green and non-green collar workers using pooled 2004-2012 National Health Interview Survey (NHIS) data linked to the Occupational Information Network Database (O*NET).

RESULTS

Green collar workers have a higher prevalence of acute joint pain as compared to non-green collar workers. Green collar workers with pain in the upper extremity joints were significantly greater than in the non-green collar workforce, for example, right shoulder [23.2% vs 21.1%], right elbow [13.7% vs 12.0%], left shoulder [20.1% vs 18.2%], and left elbow [12.0% vs 10.7%].

CONCLUSIONS

Acute joint pain reported by the emerging green collar workforce can assist in identifying at risk worker subgroups for musculoskeletal pain interventions.

Vigorous Physical Work and Obesity?-the Paradox of the Californian Farmworker Population

A good understanding of underlying causes of obesity prevalence in the farmworker population is critical in finding effective strategies to fight obesity and related chronic diseases. There is growing evidence that the population of farmworkers fares poorly with regard to health status, but available data on obesity levels and related chronic diseases is scarce or missing. This study examined the prevalence of overweight and obesity among a sample of farmworker population in California. Results of the regression model indicate that along with demographic variables such as age and gender, several lifestyle and behavioral risk factors are associated with obesity of the farmworkers. Results from this study will inform the design of intervention efforts and policies to help improve the health status of the farmworker population at the community level and beyond.

Hired crop worker injuries on farms in the United States: A comparison of two survey periods from the National Agricultural Workers Survey

BACKGROUND

Hired crop workers in the United States are at high risk of occupational injury. Targeted surveillance is important for effective occupational safety efforts.

METHODS

The National Agricultural Workers Survey was utilized to collect injury data during the years 1999, 2002-2004 (period I) and 2008-2010 (period II).

RESULTS

The overall injury rate declined between the two periods from 4.3 to 2.9/100 per full-time week-based equivalents (FTEWB ). Injury rates remained high during both periods for those with greater than 20 years farm experience (3.6 and 3.8/100 FTEWB ) and pesticide handling work (4.9 and 5.0/100 FTEWB ). Overexertion, contact with objects and equipment, and falls from height were common during both periods. Older workers comprised a greater proportion of injury cases in period II.

CONCLUSION

Overexertion that leads to sprains/strains, dangerous ladder use, and pesticide use should be targeted as important risk exposures on the farm.