Ethnic, racial, and gender variations in health among farm operators in the United States

The plantation system and the roots of the southern rural mortality penalty in the northern Blackland Prairies of Texas

In recent decades, public health researchers have observed that the health of rural people has declined relative to the health of urban people in the United States. This disparity in health and life expectancy across the rural/urban divide has been described as the Rural Mortality Penalty. However, public health researchers have also noted that health and life expectancies are not uniform across the rural United States, but vary according to race, sex, gender, and other factors. Rural health disparities also vary geospatially and are especially pronounced in the American South, leading to recent calls for greater attention to the structural factors that shape the health of rural Southerners. In this study, we take an anthropological and historically explicit approach to study the impacts of systemic violence on rural health. Specifically, we focus on farm labor within the plantation system as a context where geospatial, racial, and sexual differences in mortality, often studied in isolation, find a common historical source. Here we analyze vital records data from the post-emancipation period in the Blackland Prairies ecoregion of Texas, a period when emerging forms of plantation labor such as tenant farming, convict leasing, and migrant labor were being developed to maintain the plantation economy after the abolishment of chattel slavery. We find that the plantation system remains a strong predictor of differential mortalities in rural Texas, accounting for nearly all the variation that exists across the rural/urban divide and elucidating the complex interactions of race, sex, labor, and health in the rural South.

Sickness absence among mothers caring for a child with disability: Examining the impact of mechanical and psychosocial occupational exposures

Background

Sickness absence is more prevalent among mothers caring for children with disability compared to those caring for non-disabled children. Working in a poor working environment may worsen the impact of care burden on health outcomes among mothers of children with disabilities.

Objective

The study investigated how sickness absences are associated with mechanical and psychosocial occupational exposures among mothers caring for children with and without disabilities.

Methods

The study included children born between 2005 and 2013 and their respective mothers (N = 147, 507). Using register data from Statistics Norway, a Zero-Inflated Negative Binominal Regression was fitted to estimate the relationship between mechanical and psychosocial occupational exposures and sickness absence among employed mothers.

Results

Mothers caring for children with disability had higher levels of sickness absences, even after adjusting for psychosocial and mechanical occupational exposures, and other possible confounding factors. When the occupational exposures analysed separately, both mechanical and psychosocial indices had a significant positive main effect on the number of sick days. The main effect of psychosocial exposure was no more significant in a simultaneous analysis, but mechanical exposure maintained its significant positive effect. However, we found no statistically significant differences in the number of sick absence days between mothers of children with and without disability based on their levels of psychosocial or mechanical job exposures.

Conclusions

The findings emphasize the need of providing support to mothers caring for children with disability that help them manage occupational health risks.

Identifying Health-Related Conditions Associated with Tinnitus in Young Adults

OBJECTIVE

The present study investigated the epidemic of tinnitus in college-aged young adults. Our first objective was to identify health conditions associated with tinnitus in young adults. The second objective was to evaluate the predictive utility of some known risk factors.

STUDY DESIGN

A cross-sectional design was used to investigate the prevalence and risk factors for tinnitus.

SETTING

A questionnaire was distributed, reaching out to a large college-aged population. A total of 2258 young adults aged 18-30 years were recruited from April 2021 to February 2022.

INTERVENTIONS

A questionnaire was administered to investigate the epidemiology of tinnitus in a population of college-aged young adults.

RESULTS

About 17.7% of young adults reported bothersome tinnitus perception lasting for ≥5 min in the last 12 months. The prevalence of chronic tinnitus (bothersome tinnitus for ≥1 year) and acute tinnitus (bothersome tinnitus for <1 year) was 10.6% and 7.1%, respectively. About 19% of the study sample reported at least one health condition. Individuals reporting head injury, hypertension, heart disease, scarlet fever, and malaria showed significantly higher odds of reporting chronic tinnitus. Meningitis and self-reported hearing loss showed significant associations with bothersome tinnitus. The prevalence of chronic tinnitus was significantly higher in males reporting high noise exposure, a positive history of reoccurring ear infections, European ethnic background, and a positive health history. Risk modeling showed that noise exposure was the most important risk factor for chronic tinnitus, followed by sex, reoccurring ear infections, and a history of any health condition. A positive history of COVID-19 and self-reported severity showed no association with tinnitus. Individuals reporting reoccurring ear infections showed a significantly higher prevalence of COVID-19.

CONCLUSIONS

While young adults with health conditions are at a higher risk of reporting tinnitus, the predictive utility of a positive health history remains relatively low, possibly due to weak associations between health conditions and tinnitus. Noise, male sex, reoccurring ear infections, European ethnicity, and a positive health history revealed higher odds of reporting chronic tinnitus than their counterparts. These risk factors collectively explained about 16% variability in chronic tinnitus, which highlights the need for identifying other risk factors for chronic tinnitus in young adults.

Risk Factors for Brain Health in Agricultural Work: A Systematic Review

Certain exposures related to agricultural work have been associated with neurological disorders. To date, few studies have included brain health measurements to link specific risk factors with possible neural mechanisms. Moreover, a synthesis of agricultural risk factors associated with poorer brain health outcomes is missing. In this systematic review, we identified 106 articles using keywords related to agriculture, occupational exposure, and the brain. We identified seven major risk factors: non-specific factors that are associated with agricultural work itself, toluene, pesticides, heavy metal or dust exposure, work with farm animals, and nicotine exposure from plants. Of these, pesticides are the most highly studied. The majority of qualifying studies were epidemiological studies. Nigral striatal regions were the most well studied brain area impacted. Of the three human neuroimaging studies we found, two focused on functional networks and the third focused on gray matter. We identified two major directions for future studies that will help inform preventative strategies for brain health in vulnerable agricultural workers: (1) the effects of moderators such as type of work, sex, migrant status, race, and age; and (2) more comprehensive brain imaging studies, both observational and experimental, involving several imaging techniques.

Health and Work in Women and Men in the Welding and Electrical Trades: How Do They Differ?

Objectives

There is little information on how work tasks, demands, and exposures differ between women and men in nominally the same job. This is critical in setting workplace standards that will protect the health of both men and those women moving into less traditional work roles. Information used in setting standards is currently based almost entirely on male workers. This paper describes differences in work and health, and the relation between them, in women and men who have undergone the same trade training for the welding or electrical trades.

Method

Four cohorts were established. Two were women across Canada in the welding and electrical trades who had been in an apprenticeship since 2005. Cohorts of men in the same trades during the same period were established in the province of Alberta, Canada. Participants completed a baseline questionnaire at recruitment and were followed up every 6 months to collect detailed information on work carried out and on their health and habits. At the end of the study (up to 5 years for women and up to 3 years for men), the cohort members completed a final questionnaire including questions on mental health, harassment, and gender.

Results

The four cohorts comprised 1001 welders (447 female; 554 male) and 885 in the electrical trades (438 female; 447 male). Follow-up information was available for 89%. Women were more likely than men to have had some post-secondary education before starting their trade and were less likely to be living as married or to have a child. More welders smoked, and more men were heavy drinkers. At recruitment, more welders than those in the electrical trades reported rhinitis (sneezing and runny nose), depression, and anxiety. Female welders reported more depression (38%) than male welders (30%), compared to 24% in the electrical trades. At first follow-up, new-onset shoulder pain was more frequent in men and new-onset asthma or wheezing in welders. Within each trade, women reported less variety in tasks. Women welders were less likely to be employed in construction than men, and women were less likely to become industrial electricians. Overall, 54% of women and 46% of men reported never using respiratory protection when welding. In the end-of-study questionnaires received to date, 49% reported bullying or harassment during the apprenticeship, with higher proportions in welding than electrical trades and in women compared with men. Such harassment was reflected in higher anxiety and depression scores.

Conclusions

This is the first report on these four cohorts and demonstrates the capacity for detailed analysis of the differences in exposure and new-onset occupationally related ill-health. While women and men in the same trades appear to be doing broadly similar work, and to have similar patterns on health at the first follow-up, there are some significant differences in the types of employment and variety of tasks. The very detailed information collected will allow more precise estimates of exposures to be correlated with health outcomes at the end of the follow-up period.

Alcohol Decreases Organic Dust-Stimulated Airway Epithelial TNF-Alpha Through a Nitric Oxide and Protein Kinase-Mediated Inhibition of TACE

BACKGROUND

Farm workers in rural areas consume more alcohol than those who reside in urban areas. Occupational exposures such as agricultural work can pose hazards on the respiratory system. It is established that hog barn dust induces inflammation in the airway, including the release of cytokines such as tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6), and IL-8. We have shown that alcohol alters airway epithelial innate defense through changes in both nitric oxide (NO) and cAMP-dependent protein kinase A (PKA). Simultaneous exposure to hog barn dust and alcohol decreases inflammatory mediators, TNF-α, IL-6, and IL-8, in mice. Previously, mice exposed to both alcohol and hog barn dust showed a depleted amount of lymphocytes compared to mice exposed only to hog barn dust. Weakening of the innate immune response could lead to enhanced susceptibility to disease. In addition, mice that were co-exposed to hog barn dust and alcohol also experienced increased mortality.

METHODS

Because we recently demonstrated that PKA activation inhibits the TNF-α sheddase, TNF-α-converting enzyme (TACE), we hypothesized that an alcohol-mediated PKA pathway blocks TACE activity and prevents the normative inflammatory response to hog barn dust exposure. To delineate these effects, we used PKA pathway inhibitors (adenylyl cyclase [AC], cAMP, and PKA) to modulate the effects of alcohol on dust-stimulated TNF-α release in the bronchial epithelial cell line, BEAS-2B. Alcohol pretreatment blocked TACE activity and TNF-α release in hog barn dust-treated cells.

RESULTS

Alcohol continued to block hog barn dust-mediated TNF-α release in the presence of the particulate AC inhibitor, SQ22,536. The soluble adenylyl cyclase inhibitor, KH7, however, significantly increased the inflammatory response to hog barn dust. phosphodiesterase 4 inhibitors significantly elevated cAMP and enhanced alcohol-mediated inhibition of dust-stimulated TNF-α release. In addition, the NO synthase inhibitor, l-NMMA, also reversed the alcohol-blocking effect on dust-stimulated TNF-α.

CONCLUSIONS

These data suggest that alcohol requires a soluble cyclase-generated cAMP-PKA pathway that is dependent upon the action of NO to inhibit TACE and TNF-α release. These findings support our observations that alcohol functions through a dual NO and PKA pathway in bronchial epithelial cells.

Hearing difficulty and tinnitus among U.S. workers and non-workers in 2007

BACKGROUND

Hearing loss and tinnitus are two potentially debilitating physical conditions affecting many people in the United States. The purpose of this study was to estimate the prevalence of hearing difficulty, tinnitus, and their co-occurrence within U.S.

METHODS

Data from the 2007 National Health Interview Survey (NHIS) were examined. Weighted prevalence and adjusted prevalence ratios for self-reported hearing difficulty, tinnitus, and their co-occurrence were estimated and compared by demographic, among workers with and without occupational noise exposure, and across industries and occupations.

RESULTS

Seven percent of U.S. workers never exposed to occupational noise had hearing difficulty, 5% had tinnitus and 2% had both conditions. However, among workers who had ever been exposed to occupational noise, the prevalence was 23%, 15%, and 9%, respectively (P < 0.0001).

CONCLUSIONS

Hearing difficulty and tinnitus are prevalent in the U.S.; especially among noise-exposed workers. Improved strategies for hearing conservation or better implementation are needed.

Summary of the 2014 Alcohol and Immunology Research Interest Group (AIRIG) meeting

On November 21, 2014 the 19th annual Alcohol and Immunology Research Interest Group (AIRIG) meeting was held at Loyola University Chicago Health Sciences Campus in Maywood, Illinois. The meeting focused broadly on inflammatory cell signaling responses in the context of alcohol and alcohol-use disorders, and was divided into four plenary sessions focusing on the gut and liver, lung infections, general systemic effects of alcohol, and neuro-inflammation. One common theme among many talks was the differential roles of macrophages following both chronic and acute alcohol intoxication. Macrophages were shown to play significant roles in regulating inflammation, oxidative stress, and viral infection following alcohol exposure in the liver, lungs, adipose tissue, and brain. Other work examined the role of alcohol on disease progression in a variety of pathologies including psoriasis, advanced stage lung disease, and cancer.

Prevalence of musculoskeletal symptoms among agricultural workers in the United States: an analysis of the National Health Interview Survey, 2004-2008

Ergonomic risks from agricultural tasks can compromise musculoskeletal health of workers. This study estimated prevalence of musculoskeletal symptoms in a sample representing almost 2 million US agricultural industry workers. This study used National Health Interview Survey data from 2004 to 2008. Weighted prevalence was calculated by demographic and employment factors. Prevalence ratios were calculated using generalized linear models with the Poisson distribution assumption. Prevalence rates of low back and neck pain in the previous 3 months were 24.3% and 10.5%, respectively, among agricultural workers. Monthly prevalence of joint pain was 17.0% for hips/knees, 9.8% for shoulders, 9.5% for wrists/hands, 5.4% for elbows, and 4.7% for ankles/toes. Agricultural workers had a significantly higher prevalence of shoulder pain than all other industry workers (prevalence ratios [PR] = 1.28, 95% confidence interval [CI]: 1.02-1.61). This study provides detailed national estimates of musculoskeletal symptom prevalence to understand the burden and the need for intervention among agricultural workers.

Gender in occupational health research of farmworkers: a systematic review

Background

Farmwork is one of the most hazardous occupations for men and women. Research suggests sex/gender shapes hazardous workplace exposures and outcomes for farmworkers. This paper reviews the occupational health literature on farmworkers, assessing how gender is treated and interpreted in exposure-outcome studies.

Methods

The paper evaluates peer-reviewed articles on men and women farmworkers' health published between 2000 and 2012 in PubMed or SCOPUS. Articles were identified and analyzed for approaches toward sampling, data analysis, and use of exposure indicators in relation to sex/gender.

Results

18% of articles reported on and interpreted sex/gender differences in health outcomes and exposures. Sex/gender dynamics often shaped health outcomes, yet adequate data was not collected on established sex/gender risk factors relating to study outcomes.

Conclusion

Research can better incorporate sex/gender analysis into design, analytical and interpretive approaches to better explore its mediation of health outcomes in light of emerging calls to mainstream gender research. Am. J. Ind. Med. 57:1344–1367, 2014. © 2014 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals, Inc. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Acute symptoms associated with chemical exposures and safe work practices among hospital and campus cleaning workers: a pilot study

BACKGROUND

Cleaning workers are regularly exposed to cleaning products containing hazardous chemicals. This study investigated acute symptoms associated with chemical exposures among cleaning workers and their safe work practices.

METHODS

This cross-sectional study included 183 cleaning workers employed in an academic medical center and affiliated health sciences campuses in Northern California. Data on respiratory, eye, skin, neurological, and gastrointestinal symptoms and occupational factors were collected by in-person interviews or self-administered questionnaires.

RESULTS

Chemical-related symptoms (several times monthly or more often) were more common among workers who performed patient area cleaning (44%) than hospital custodians (36%) or campus custodians (28%). After controlling for age, sex, and job title, symptoms were associated with exposure to carpet cleaners (OR = 2.98, 95% CI 1.28-6.92), spray products (OR = 2.82, 95% CI 1.16-6.82), solvents (OR = 2.71, 95% CI 1.20-6.15), and multi-purpose cleaners (OR = 2.58, 935% CI 1.13-6.92). Except for gloves, regular use of personal protective equipment was infrequent.

CONCLUSIONS

Study findings suggest a need for additional interventions such as use of less toxic products to reduce health risks among cleaning workers.

Gender inequalities in occupational health related to the unequal distribution of working and employment conditions: a systematic review

Introduction

Gender inequalities exist in work life, but little is known about their presence in relation to factors examined in occupation health settings. The aim of this study was to identify and summarize the working and employment conditions described as determinants of gender inequalities in occupational health in studies related to occupational health published between 1999 and 2010.

Methods

A systematic literature review was undertaken of studies available in MEDLINE, EMBASE, Sociological Abstracts, LILACS, EconLit and CINAHL between 1999 and 2010. Epidemiologic studies were selected by applying a set of inclusion criteria to the title, abstract, and complete text. The quality of the studies was also assessed. Selected studies were qualitatively analysed, resulting in a compilation of all differences between women and men in the prevalence of exposure to working and employment conditions and work-related health problems as outcomes.

Results

Most of the 30 studies included were conducted in Europe (n=19) and had a cross-sectional design (n=24). The most common topic analysed was related to the exposure to work-related psychosocial hazards (n=8). Employed women had more job insecurity, lower control, worse contractual working conditions and poorer self-perceived physical and mental health than men did. Conversely, employed men had a higher degree of physically demanding work, lower support, higher levels of effort-reward imbalance, higher job status, were more exposed to noise and worked longer hours than women did.

Conclusions

This systematic review has identified a set of working and employment conditions as determinants of gender inequalities in occupational health from the occupational health literature. These results may be useful to policy makers seeking to reduce gender inequalities in occupational health, and to researchers wishing to analyse these determinants in greater depth.

Immigration, employment relations, and health: Developing a research agenda

BACKGROUND

International migration has emerged as a global issue that has transformed the lives of hundreds of millions of persons. Migrant workers contribute to the economic growth of high-income countries often serving as the labour force performing dangerous, dirty and degrading work that nationals are reluctant to perform.

METHODS

Critical examination of the scientific and "grey" literatures on immigration, employment relations and health.

RESULTS

Both lay and scientific literatures indicate that public health researchers should be concerned about the health consequences of migration processes. Migrant workers are more represented in dangerous industries and in hazardous jobs, occupations and tasks. They are often hired as labourers in precarious jobs with poverty wages and experience more serious abuse and exploitation at the workplace. Also, analyses document migrant workers' problems of social exclusion, lack of health and safety training, fear of reprisals for demanding better working conditions, linguistic and cultural barriers that minimize the effectiveness of training, incomplete OHS surveillance of foreign workers and difficulty accessing care and compensation when injured. Therefore migrant status can be an important source of occupational health inequalities.

CONCLUSIONS

Available evidence shows that the employment conditions and associated work organization of most migrant workers are dangerous to their health. The overall impact of immigration on population health, however, still is poorly understood and many mechanisms, pathways and overall health impact are poorly documented. Current limitations highlight the need to engage in explicit analytical, intervention and policy research.