Multiple Exposures and Coexposures to Occupational Hazards Among Agricultural Workers: A Systematic Review of Observational Studies

Racial, Ethnic, and Immigrant Generational Disparities in Physically Strenuous and Hazardous Work Conditions

Despite the importance of work in adult life, research on the social determinants of health often ignores its effects. We examine race/ethnic, immigrant generational, and gender differentials in exposure to work conditions associated with poor health outcomes, using a nationally-representative sample of adults. On average, Latino 1st generation workers are more exposed to strenuous and hazardous work conditions than other workers, even after adjusting for sociodemographic differences. Exposure is lower for 2nd and 3rd generation Latinos. In contrast, Asian 1st generation men often have the lowest exposure levels of all groups and Asian 2nd and 3rd generation men have higher levels of exposure than the first generation, primarily due to intergenerational differences in education. Asian 1st generation women have higher exposures than those in the 2nd or 3rd generation. These results illustrate the importance of considering work conditions in research and policy related to the social determinants of health.

Association of immunotoxicological indices with lung cancer biomarkers in poultry, grape, and rose farming workers

Exposure to occupational hazards like dust, pesticides, diesel emission particles, or physical hazards in the agricultural sector is known to cause adverse health effects on farm workers. Our study aimed at addressing the association of immunomodulatory status with plasma levels of lung cancer biomarkers in farming population, attempting to recognition of vulnerable farming group. Blood samples from apparently healthy 51 chicken husbandry, 19 grape orchard, and 21 rose greenhouse workers were subjected to evaluate plasma levels of two representative lung cancer biomarkers, pro-gastrin releasing peptide (Pro-GRP) and cytokeratin fragment 19 (CYFRA 21-1). Peripheral blood mononuclear cells obtained from farmers were used for natural killer (NK) cell phenotyping and cytokines (interferon-gamma, IFN-γ and interleukin-13, IL-13) profiling in the culture supernatant. Compared to the rose greenhouse farmers, the grape orchard and chicken husbandry workers revealed a significantly upregulated plasma Pro-GRP and CYFRA 21-1 level. A low proportion of NK cells was observed among the female grape orchard workers and a lowered IFN- γ:IL-13 ratio was seen in the grape and chicken husbandry workers than the rose workers. Our findings imply that grape orchard and chicken husbandry workers have more disturbed immune homeostasis implicated with augmentation in the levels of lung cancer biomarkers than the rose greenhouse workers.

Work-Related Musculoskeletal Disorders Among Farmers in the Southeast Asia Region: A Systematic Review

Background

Southeast Asia has many people who work in the agriculture sector. Not many stakeholders pay special attention to the health of farmers, even though they are exposed to various types of hazards. One of the most common health complaints among farmers is related to work-related musculoskeletal disorders (WMSDs). This study aims to assess the prevalence of WMSDs and factors associated with them among farmers in Southeast Asia.

Methods

A literature search on PubMed, ScienceDirect, Scopus, and EBSCO was conducted. Articles were included if they studied ergonomic problems among farmers from 11 countries in the Southeast Asia region and were published during 2015-2022. The Critical Appraisal Skills Program was used to evaluate the quality of the articles. The search process and retrieval process reflected PRISMA's recommendation.

Result

There were 14 studies found from 3 countries that had published articles in PubMed and ScienceDirect, including Thailand [8], Indonesia [4], and Malaysia [2]. The prevalence of WMSDs in Thailand, Indonesia, and Malaysia was 78,31%, 81,27%, and 88,39%, respectively. Common factors associated with WMSDs include age, sex, smoking habits, drinking alcohol habits, working period (years), type of work, awkward position, non-ergonomic equipment, repetitive movements, and lifting heavy loads.

Conclusion

The prevalence of WMSDs among farmers in Southeast Asia is considerably high. Effective intervention is essential for reducing the prevalence and protecting workers' health and well-being.

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.

The Dilemma and Path of Rural Environmental Governance in China: From the Perspective of a Community with a Shared Future

With the aim of achieving the goal of ecological livability in Chinese rural society, the issue of rural environmental governance has received great attention from the CCP and the government. However, due to local governments' model of development in exchange for economic interests and the "urban and rural binary" structure of environmental governance, rural environmental governance faces many dilemmas, such as lack of normative standards, lack of environmental governance subjects, and lack of judicial security. In order to improve the development of rural ecological civilization and realize ecologically friendly agriculture, this paper proposes a solution path for rural environmental governance from the perspective of the idea of the community with a shared future for humanity. Specifically, this solution path includes establishing the concepts of cooperation and governance of environmental protection, improving villagers' participation in environmental protection, balancing economic and environmental interests in rural environmental governance, and building a long-term mechanism for the rule of law in rural environmental governance.

Occupational health surveillance and detection of emerging occupational diseases among Taiwan farmers, through analysis of national-based farmers' and medico-administrative databases

OBJECTIVES

The purpose of this study was to identify occupational injuries and diseases associated with agriculture in Asia, to provide a reference for prevention and hypotheses for future research.

METHODS

We matched data on agricultural workers (n = 963,124) enrolled in Taiwan's national Farmers Health Insurance since its inception in 1989, to general population controls of the same age, gender, and township. The study population was linked to the National Health Insurance Research Database from 2001 to 2016 for inpatient cases. Logistic regression was used to assess odds ratios for outcomes.

RESULTS

Farmers had 2.76 times the risk of mycotic corneal ulcer (95% CI: 1.96-3.87) and 1.65 times the risk of typhus fever infections (95% CI: 1.47-1.85) compared to the general population. The odds ratio for poisonous animal bites was 2.22 (95% CI: 2.07-2.38), for falling into a storm drain or manhole was 2.04 (95% CI: 1.30-3.20), and for toxic effects from pesticides was 2.01 (95% CI: 1.92-2.11). The toxic effects of organophosphate and carbamate insecticides were correlated with the cultivation of rice, fruit trees, and flowers. Q fever and motorcycle accidents were associated with fruit tree cultivation.

CONCLUSIONS

The study identifies agricultural occupational injuries and diseases that may inform occupational health policy and the development of prevention priorities to prevent occupational hazards for farmers.

Thiram induces myocardial oxidative damage and apoptosis in broilers via interfering their cardiac metabolism

Thiram is a dithiocarbamate pesticide extensively used as a fungicide to preserve crops and seeds. Long-term exposure to thiram causes potential harm to the health of human beings and animals. So far, most of the researches on thiram focused on erythrocyte toxicity, immune system, kidney damage, and tibial dyschondroplasia; however, there is less data on cardiac toxicity. In this study, we examined cardiac histopathology, inflammatory factors, oxidative stress indicators, and apoptosis markers in the heart of broilers that were exposed to thiram. According to our findings, the continuous exposure to thiram caused pathological changes and abnormal function of myocardial tissues with increased level of inducible nitric oxide synthase (iNOS), inflammatory factors (IL-6, IL-8, TNF-α and NF-κB), and decreased level of anti-inflammatory factor (IL-10). In addition, thiram significantly upregulated the protein expression of cleaved-caspase 3, cleaved-PARP, and caused cardiomyocyte apoptosis. Meanwhile, the expression of heat shock proteins (HSP60, HSP70, HSP90) markedly decreased in the thiram-treated groups. An excessive accumulation of peroxidation products (MDA, H₂O₂), a decrease in T-AOC, and antioxidant activity enzymes (T-SOD, GST and GPX) were also noticed, all of which led to oxidative stress and activation of Nrf2 signal pathway by up-regulating key target genes (HO-1 and SODs). Thiram-induced metabolites were further identified via non-targeted metabonomic analysis. Correlation analysis revealed eighteen differentially expressed metabolites, closely related to cardiac injury. Importantly, thiram primarily affected the taurine and hypotaurine metabolism, pyrimidine metabolism as well as glycerol metabolism. Collectively, our study suggests that thiram could cause cardiotoxicity by interfering with taurine and hypotaurine metabolism, pyrimidine metabolism, and glycerolipid metabolism, which further induce oxidative stress via triggering Nrf2 signal pathway. This study may provide new evidence for the molecular mechanism of cardiotoxicity caused by thiram and resonate the alarm for animals and workers who have been exposed to thiram for a long time.

Workplace hazards and health among informally employed domestic workers in 14 cities, United States, 2011-2012: Using four approaches to characterize workers' patterns of exposures

BACKGROUND

We characterized informally employed US domestic workers' (DWers) exposure to patterns of workplace hazards, as well as to single hazards, and examined associations with DWers' work-related and general health.

METHODS

We analyzed cross-sectional data from the sole nationwide survey of informally employed US DWers with work-related hazards data, conducted in 14 cities (2011-2012; N = 2086). We characterized DWers' exposures using four approaches: single exposures (n = 19 hazards), composite exposure to hazards selected a priori, classification trees, and latent class analysis. We used city fixed effects regression to estimate the risk ratio (RR) of work-related back injury, work-related illness, and fair-to-poor self-rated health associated with exposure as defined by each approach.

RESULTS

Across all four approaches-net of individual, household, and occupational characteristics, and city fixed effects-exposure to workplace hazards was associated with increased risk of the three health outcomes. For work-related back injury, the estimated RR associated with heavy lifting (the single hazard with the largest RR), exposure to all three hazards selected a priori (worker did heavy lifting, climbed to clean, and worked long hours) versus none, exposure to the two hazards identified by classification trees (heavy lifting, verbally abused) versus "no heavy lifting," and membership in the most- versus least-exposed latent class were, respectively, 3.4 (95% confidence interval [CI] 2.7-4.1); 6.5 (95% CI 4.8-8.7); 4.4 (95% CI 3.6-5.3), and 6.6 (95% CI 4.6-9.4).

CONCLUSIONS

Measures of joint work-related exposures were more strongly associated than single exposures with informally employed US DWers' health profiles.

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.

The effects of co-exposure to methyl paraben and dibutyl phthalate on cell line derived from human skin

Data on the cumulative effects of chemical substances are necessary for the proper risk assessment, but their availability is still insufficient. The aim of the study was to evaluate the cytotoxic effect of methyl paraben (MePB) and dibutyl phthalate (DBP) on the cells of the skin line (A431) and to compare the cytotoxic effects of the tested substances after single application to A431 cells with the effects of an equimolar/equitoxic (1:1) binary mixture of these compounds as well as their mixtures in ratio 1:3: and 3:1. On the basis of the obtained results, it was found that there were interactions between the tested compounds in terms of cytotoxic effect on A431, assessed on the basis of metabolic activity of cells (MTT test) and integrity of their cell membranes (NRU test). The obtained values of synergy coefficients (SI) and isobolographic analysis indicate that between the tested chemicals in a two-component equimolar mixture (1:1) there is a synergism of action, which, at a high DBP content in the mixture (> 50%) turned into antagonism. Observations using a holotomographic microscope show morphological changes in A431 cells after exposure to both DBP and MePB separately and binary mixtures of these compounds, compared to untreated cells. The observed changes in cell morphology seem to be more pronounced when the cells are exposed to the binary mixtures of DBP and MePB than when exposed to these substances individually, which may confirm the synergy of cytotoxic activity between them (this phenomenon was observed for the higher of the tested concentrations in all tested proportions). It is important to consider such effects when considering the effects of cumulative exposure in the risk assessment in order not to underestimate the risk of adverse effects associated with exposure to chemical mixtures.

A Case Study about Joining Databases for the Assessment of Exposures to Noise and Ototoxic Substances in Occupational Settings

Evaluating risks associated with multiple occupational exposures is no easy task, especially when chemical and physical nuisances are combined. In most countries, public institutions have created databases, which gather extensive information on occupational exposures or work-related diseases. Unfortunately, these tools rarely integrate medical and exposure information, and, above all, do not take into account the possible adverse effects of co-exposures. Therefore, an attempt to exploit and join different existing databases for the assessment of the health effects of multiple exposures is described herein. This case study examines three French databases describing exposures to noise and/or ototoxic chemicals (i.e., toxic to the ear) and the incidence rate of occupational deafness in different sectors. The goals were (1) to highlight occupational sectors where the workers are the most (co)exposed and (2) to determine whether this approach could confirm the experimental data showing that this co-exposure increases the risk of developing hearing loss. The results present data per occupational sector exposing workers to noise only, ototoxic chemicals only, noise and ototoxic chemicals, and neither of these two nuisances. The ten sectors in which the proportion of exposed workers is the highest are listed. This analysis shows that the rate of hearing loss in these sectors is high but does not show an increased incidence of hearing loss in co-exposed sectors.

Towards a software architecture to manage occupational safety at grain handling and storage facilities

The study had as objective to evaluate occupational hazards on grain storage unit to define a conceptual model, implemented in an algorithm to manage the grains storage facilities safety standards compliance. Sampling points location were defined for static quantification of noise, dust and heat stress hazards in grains pre-processing operations to indicate the effectiveness of the control measures implemented. Safety standards applied to grain handling and storage facilities were identified and selected. Chart flows were elaborated to the algorithm logics and conceptual modeling. The highest level of noise was present in the grain cleaning operation (99.1 dB), while the expedition operation has the highest level of dust (20.27%). The heat stress was present in the grain drying operation (43.64 WBGT). Noise analysis did not show a difference between grains, only between operations. The flow of corn grain mass caused higher dust concentrations in the expedition operation. The method applied to characterize and quantify the hazards in grain storage units was satisfactory, and it is recommended as standard, for use in corn and soybean grains handling and storage units. The algorithm to manage occupational safety at storage facilities collaborates to monitor the safety compliance on postharvest operations.

Application of Pattern Mining Methods to Assess Exposures to Multiple Airborne Chemical Agents in Two Large Occupational Exposure Databases from France

Surveys of the French working population estimate that approximately 15% of all workers may be exposed to at least three different chemical agents, but the most prevalent coexposure situations and their associated health risks remain relatively understudied. To characterize occupational coexposure situations in France, we extracted personal measurement data from COLCHIC and SCOLA, two large administrative occupation exposure databases. We selected 118 chemical agents that had ≥100 measurements with detected concentrations over the period 2010-2019, including 31 carcinogens (IARC groups 1, 2A, and 2B). We grouped measurements by work situations (WS, combination of sector, occupation, task, and year). We characterized the mixtures across WS using frequent itemset mining and association rules mining. The 275,213 measurements extracted came from 32,670 WS and encompassing 4692 unique mixtures. Workers in 32% of all WS were exposed to ≥2 agents (median 3 agents/WS) and 13% of all WS contained ≥2 carcinogens (median 2 carcinogens/WS). The most frequent coexposures were ethylbenzene-xylene (1550 WS), quartz-cristobalite (1417 WS), and toluene-xylene (1305 WS). Prevalent combinations of carcinogens also included hexavalent chromium-lead (368 WS) and benzene-ethylbenzene (314 WS). Wood dust (6% of WS exposed to at least one other agent) and asbestos (8%) had the least amount of WS coexposed with other agents. Tasks with the highest proportions of coexposure to carcinogens include electric arc welding (37% of WS with coexposure), polymerization and distillation (34%), and construction drilling and excavating (34%). Overall, the coexposure to multiple chemical agents, including carcinogens, was highly prevalent in the databases, and should be taken into account when assessing exposure risks in the workplace.

Physical exertion at work and addictive behaviors: tobacco, cannabis, alcohol, sugar and fat consumption: longitudinal analyses in the CONSTANCES cohort

We examined the prospective association of physical exertion at work with subsequent tobacco, cannabis, alcohol use, and sugar and fat consumption. Volunteers of the French population-based CONSTANCES cohort currently employed were included from 2012 to 2017 for tobacco and cannabis outcomes (n = 100,612), and from 2012 to 2016 for alcohol and sugar and fat outcomes (n = 75,414). High level of physical exertion at work was defined as a score ≥ 12 at the Rating Perceived Exertion Borg scale. Substance use was self-reported and diet rich in sugar and fat was obtained from principal component analysis and analyzed as quartiles. Generalized linear models computed odds of substance use and sugar and fat consumption at follow-up according to baseline physical exertion at work, while adjusting for sociodemographic factors, depressive symptoms and baseline level of consumption. High physical exertion was associated with tobacco use with dose-dependent relationships. It was also associated with increased odds of cannabis use at least once per month compared to no use in the past and with increased odds of diet rich in sugar and fat. Hence, the role of physical exertion at work on tobacco and cannabis use and diet rich in sugar and fat should be tackled for information and prevention strategies.

Risk of musculoskeletal disorders in pepper cultivation workers

Agricultural workers have an increased risk of musculoskeletal disorders, mainly due to the manual nature of the work. This study assesses the level of physical well-being in pepper cultivation workers in Almería (Spain). The objective was to analyze pepper cultivation tasks performed in the Almería-type greenhouse, using the OWAS (Ovako Working Posture Assessment System) and RULA (Rapid Upper Limb Assessment) methods. The OWAS results showed a normal posture percentage of 53 %, a medium risk of 30 %, a high risk of 16 %, and a very high risk of 1 %. The body areas most affected were the back and legs. The RULA assessment found high risk/action levels, with 50 % of the postures corresponding to level 3, 35 % to level 4, and 15 % to level 2. Improvements are therefore proposed; these include: redesigning tasks, mechanization, training, team development, and improving the workers' physical condition. The OWAS and RULA data may have overestimated the results, as workers do not appear to be limited in performing tasks and do not normally request sick leave.

Cancer and occupational exposure to pesticides: an umbrella review

Purpose

The aim was to identify the scope of the epidemiology literature reviewed regarding the risk of cancer as related to occupational exposure to pesticides and to compare regulatory toxicity results where feasible.

Methods

Review studies of breast, lung, prostate, non-Hodgkin lymphoma, and colorectal cancer were identified from the published literature from 2010 to 2020 using a priori inclusion and exclusion criteria. Epidemiology observations were first assessed and then compared against carcinogenicity profiles derived from regulatory toxicology studies.

Results

Several active ingredients were associated with specific cancer but overall, there was neither strong nor consistent epidemiologic data supportive of a positive association between pesticide exposure in occupational settings and cancer. Authors noted common themes related to the heterogeneity of exposure, study design, control for confounders, and the challenge to collect these data reliably and validly with an adequate sample size. Toxicology studies in laboratory animals that assessed carcinogenic potential did not reveal cancer outcomes that were concordant with reported epidemiologic findings.

Conclusions

Farming and pesticides represent diverse exposures that are difficult to quantify in epidemiologic studies. Going forward, investigators will need creative and novel approaches for exposure assessment. Integration of epidemiologic and toxicological studies with attention to biological plausibility, mode of toxicological action and relevance to humans will increase the ability to better assess associations between pesticides and cancer.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00420-020-01638-y.

Important Difference between Occupational Hazard Exposure among Shift Workers and Other Workers; Comparing Workplace before and after 1980

Improving health and safety at work has been an important issue for the European Union since the 1980s. The existing literature supports that shift work is associated with multiple indicators of poor health but frequently neglects the potential impact of occupational hazards. This study aims at describing and comparing the exposure to different workplace hazards among shift and other workers before and after 1980. Exposure to different workplace hazards (noise, dust, pollutant, and other physical stressors) were analyzed among 119,413 participants from the UK Biobank cohort. After stratifying the analyses before and after 1980, exposure was compared between shift and other workers. Potential confounding variables (sex, age, ethnicity, education level, occupational category, and neuroticism) were adjusted for in the log-binomial regression. Shift workers had a higher prevalence ratio (PR) than other workers of being exposed to almost all identified hazards both before or after 1980. They were also more likely to be exposed to multiple hazards compared to other workers, both before 1980 (PR: 1.25; 95% CI: 1.21-1.30) and after 1980 (PR: 1.34; 95% CI: 1.30-1.38). The prevalence of all measured risk factors was higher after 1980 than before 1980 among shift workers. Of note, the work environment has improved overall for other workers. Our findings suggest that changes at the workplace have benefited other workers more than shift workers as they are still more exposed to all occupational hazards.

Occupational risk factors in health of broiler-farm workers: A systematic review

The present study aimed to identify gaps in literature regarding occupational risks to broiler farming workers. A systematic review was performed in which inclusion criteria were workers in poultry farms. The search was done between May and June 2019 with online papers. Keywords were "poultry farmer," "poultry worker," and "poultry workers" as terms of an axis of a theoretical framework. Results indicated as predominant topics lung diseases, nasal mucosa or paranasal sinus contamination, and aflatoxicosis. The identified gaps in scientific publications are related to mitigation of occupational risks. Prevalent described risks are associated to exposure to chemicals gases, vapors and aerosols, biological hazards (micro-organisms), ergonomic risks, wrong working posture, excessive body movement and inadequate behaviors. Preventive policies about poultry farmer's health and safety needs to be adopted to reduce potentially dangerous risk factors and increase productivity.

Effects of Occupational Hazards on Job Stress and Mental Health of Factory Workers and Miners: A Propensity Score Analysis

This study is to evaluate the effects of different occupational hazards on job stress and mental health of factory workers and miners. A total of 6120 workers from factories and mining enterprises in seven districts and one district of Urumqi were determined using the stratified cluster random sampling method. The Effort-Reward Imbalance (ERI) questionnaire and the Symptom Checklist-90 (SCL-90) were used to evaluate the effects of occupational hazard factors on job stress and mental health of workers. The propensity score analysis was used to control the confounding factors. The occupational hazards affecting job stress of workers were asbestos dust (OR = 1.3, 95% CI: 1.09-1.55), benzene (OR = 1.25, 95% CI: 1.10-1.41), and noise (OR = 1.39, 95% CI: 1.22-1.59). The occupational hazards affecting the mental health of workers were coal dust (OR = 1.19, 95% CI: 1.02-1.38), asbestos dust (OR = 1.58, 95% CI: 1.32-1.92), benzene (OR = 1.28, 95% CI: 1.13-1.47), and noise (OR = 1.23, 95% CI: 1.07-1.42). Different occupational hazards have certain influence on job stress and mental health of factory workers and miners. The enhancements in occupational hazard and risk assessment, occupational health examination, and occupational protection should be taken to relieve job stress and enhance the mental health of factory workers and miners.

Working Conditions and Mental Health Status Related With Occupational Injury of Korean Outdoor Workers

OBJECTIVE

This study investigated the working conditions and mental health status linked to occupational injury among Korean outdoor workers.

METHODS

Socioeconomic and occupational characteristics were collected using self-reported questionnaires from 26,468 paid workers selected using the 5th Korean Working Conditions Survey. The relationships among mental health issues, occupational injury, and working outdoors were estimated by logistic regression.

RESULTS

Outdoor workers were relatively older with lower educational levels and income, worked longer, and had greater exposure to occupational hazards, higher occupational injury rate, significantly higher risk of sleep disturbances, and higher occupational injury rates due to sleep disturbances than non-outdoor workers.

CONCLUSIONS

There was a significant relationship among working outdoors, sleep quality, and mental health-related issues due to exposure to occupational hazards. Specific occupational health and safety strategies are needed to protect the mental health of outdoor workers.

Carpal tunnel syndrome and exposure to work-related biomechanical stressors and chemicals: Findings from the Constances cohort

Objective

To investigate the effects of co-exposure to biomechanical wrist stressors and chemicals on the risk of CTS in a large cohort of French workers.

Methods

Prospective study using the data collected at baseline and at the first 12 month-follow-up for the 18,018 participants included in the population-based Constances cohort between 2012 and 2015. CTS at follow-up and exposure to biomechanical wrist stressors and chemicals at baseline were assessed using a self-administered questionnaire. Associations between CTS and co-exposure to biomechanical wrist stressors and chemicals were studied using multivariate logistic regression models, adjusted for personal/medical factors.

Results

184 men (2.1%, 95%CI 1.8–2.4) and 331 women (3.6%, 3.2–3.9) free from chronic hand symptoms at baseline declared suffering from unilateral/bilateral CTS at follow-up. A potentiating effect of co-exposure to biomechanical wrist stressors and chemicals on the risk of CTS was found for both genders, with higher OR in the co-exposure group (OR = 3.38 [2.29–5.01] in men and OR = 4.12 [2.73–6.21] in women) than in the biomechanical exposure group (OR = 2.14 [1.51–3.03] in men and OR = 2.19 [1.72–2.78] in women) compared to no exposure group.

Conclusions

The study showed an association between CTS and co-exposure to biomechanical wrist stressors and chemicals, after adjustment for the main personal and medical factors. This finding should be confirmed using more objective case definition of CTS and assessment of the chemical exposure before drawing conclusions on the possible synergistic effects of mechanical stressors and chemical on the median nerve.

Occupational exposure to pesticides and associated health effects among greenhouse farm workers

The number and production capacities of greenhouse farms have been increased across the globe, driven by an effort for addressing food security problems related to the rapid population growth and the effects of climate change. As a result, there was a large increase in the number of greenhouse farm workers who are typically involved in chemical preparations and pesticide sprayings, crop harvesting, and greenhouse maintenance activities. Considering the enclosed architecture of the greenhouse farm design and the frequent application of pesticides, the objective of this review was to characterize pesticide exposure levels and resultant health effects among greenhouse farm workers. While most health assessment studies were mainly based on self-reported symptoms, this review showed limited epidemiological and clinical studies on the assessment of the health effects of pesticide exposure on greenhouse workers' health. Reproductive disorders, respiratory symptoms, neurological symptoms, and skin irritations were the most reported health effects among greenhouse farm workers. Additionally, there were limited studies on respirable pesticide-borne fine and ultrafine particulate matters in greenhouse farms. Ventilation systems and indoor environmental conditions of greenhouse farms were not designed according to specifications of the American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE). Among recommendations provided, long-term exposure assessments of pesticide effects on children born by greenhouse farm workers should be considered in future research. Also, compliance with ASHRAE indoor ventilation and environmental standards will be very important in reducing pesticide exposure and health effects among greenhouse farm workers.

Carpal Tunnel Syndrome Among Male French Farmers and Agricultural Workers: Is It Only Associated With Physical Exposure?

Background

Exploratory study to investigate whether co-exposure to physical wrist stressors and chemicals is associated with carpal tunnel syndrome (CTS) in French male farmers and agricultural workers.

Methods

Cross-sectional study of 711 men aged 30–65 years and working as either farmers or agricultural workers in 2009–2010 within a cohort covered by the French Agricultural Workers' and Farmers' Mutual Benefit Fund. CTS and exposure to physical wrist stressors and chemicals were assessed using a self-administered questionnaire. Associations between CTS and personal/medical factors, exposure to physical wrist stressors, exposure to chemicals, and co-exposure to physical wrist stressors and chemicals were studied using multivariate logistic regression models.

Results

Forty-four men {5.6% [95% confidence interval (CI) 4.0–7.7]} reported that they had suffered from unilateral/bilateral CTS during the last 12 months. CTS was associated with age, current smoking [odds ratio (OR) = 2.1 (1.0–4.5)], and exposure to physical wrist stressors [OR = 2.6 (1.1–5.9)]. An association was found between CTS and co-exposure to physical wrist stressors and chemicals [OR = 3.3 (0.8–14.3), p = 0.044] in comparison with the no-exposure group.

Conclusions

This exploratory study shows an association of CTS with exposure to biomechanical wrist stressors in male farmers and agricultural workers and suggests an association of CTS with co-exposure to physical wrist stressors and chemicals. Owing to the limitations of the study, this result must be confirmed by a prospective study with objective assessments of the outcome and exposure before drawing conclusions on the possible synergistic effects of mechanical stressors and chemicals on the impairment of the median nerve.

Agricultural Dust Exposures and Health and Safety Practices among Western Australian Wheatbelt Farmers during Harvest

Background: Agricultural farmworkers are routinely exposed to high levels of airborne dust particles that have been linked to adverse health outcomes. Methods: This study measured personal and environmental exposures to dust particulates by farmworkers during harvesting activities. Farmers completed a workplace survey with regards to their health and safety awareness and practices and researchers observed general farm safety practices on selected farms using a checklist. Results: In this study, farmers were noted to commonly work extended hours and shifts during harvest due to rigid timing deadlines. Results showed that 40% of farmers were exposed to concentrations of inhalable particles greater than SafeWork Australia’s workplace exposure standards for grain dusts, assuming a 16 h working day over 5 shifts. Twenty-two percent were exposed to concentrations that were above the adjusted standard for 12 h shifts. Survey results showed that three-quarters of farm owners provided new workers with some type of induction related to farm safety, however this was mostly undertaken in an arbitrary manner. Despite noting that farming was a dusty occupation and reporting to use protective measures to reduce harmful dust exposures, no workers were observed to wear respiratory protection when working outside of the protection of a vehicle cabin. Conclusion: This study identified substantial gaps in health and safety knowledge among farm managers and workers, and improved education and training are highly recommended.

The Safe Use of Pesticides: A Risk Assessment Procedure for the Enhancement of Occupational Health and Safety (OHS) Management

The attention paid to the use of pesticides has increased notably in recent years as demonstrated by the issue of laws and regulations requiring their safe and environmentally-conscious use (e.g. Directive 2009/128/EC and Regulation (EC) no. 1272/2008). Despite the benefits that can be achieved by pursuing the targets of stricter legislative framework, the difficulties for farmers in complying with it are remarkable, especially for small-sized companies. In fact, in contrast to other occupational health and safety (OHS) contexts, in the case of pesticides even a preliminary analysis on the relationship between pesticide use and the consequent exposure risks for the workers is a complex task. In order to reduce the above-mentioned gap, the present study is focused on the development of an easy-to-use tool for carrying out occupational risk assessment of agricultural activities related to the use of pesticides. The procedure was developed by starting from the Agricultural Health Study (AHS) approach and its improvements, and continuing to the thorough development of a tool for preliminary risk assessment, providing a simplified model for its practical application by farmers. A case study concerning olive cultivation was used for its first verification. The results achieved should be considered as an initial step for the promotion of safer practices when using pesticides, providing a consistent base for their further validation.