Prevalence of musculoskeletal disorders among immigrant Latino farmworkers and non-farmworkers in North Carolina

Commonly Used Subjective Effort Scales May Not Predict Directly Measured Physical Workloads and Fatigue in Hispanic Farmworkers

In North America, Hispanic migrant farmworkers are being exposed to occupational ergonomic risks. Due to cultural differences in the perception and reporting of effort and pain, it was unknown whether standardized subjective ergonomic assessment tools could accurately estimate the directly measured their physical effort. This study investigated whether the subjective scales widely used in exercise physiology were associated with the direct measures of metabolic load and muscle fatigue in this population. Twenty-four migrant apple harvesters participated in this study. The Borg RPE in Spanish and the Omni RPE with pictures of tree-fruit harvesters were used for assessing overall effort at four time points during a full-day 8-h work shift. The Borg CR10 was used for assessing local discomfort at the shoulders. To determine whether there were associations between the subjective and direct measures of overall exertion measures, we conducted linear regressions of the percentage of heart rate reserve (% HRR) on the Borg RPE and Omni RPE. In terms of local discomfort, the median power frequency (MPF) of trapezius electromyography (EMG) was used for representing muscle fatigue. Then full-day measurements of muscle fatigue were regressed on the Borg CR10 changes from the beginning to the end of the work shift. The Omni RPE were found to be correlated with the % HRR. In addition, the Borg RPE were correlated to the % HRR after the break but not after the work. These scales might be useful for certain situations. In terms of local discomfort, the Borg CR10 were not correlated with the MPF of EMG and, therefore, could not replace direct measurement.

ICON 2020-International Scientific Tendinopathy Symposium Consensus: A Scoping Review of Psychological and Psychosocial Constructs and Outcome Measures Reported in Tendinopathy Clinical Trials

OBJECTIVE

To identify and describe the psychological and psychosocial constructs and outcome measures used in tendinopathy research.

DESIGN

Scoping review.

LITERATURE SEARCH

We searched the PubMed, EMBASE, Scopus, Web of Science, PEDro, CINAHL, and APA PsychNet databases on July 10, 2021, for all published studies of tendinopathy populations measuring psychological and psychosocial factors.

STUDY SELECTION

Studies using a clinical diagnosis of tendinopathy or synonyms (eg, jumper's knee or subacromial impingement) with or without imaging confirmation.

DATA SYNTHESIS

We described the volume, nature, distribution, and characteristics of psychological and psychosocial outcomes reported in the tendinopathy field.

RESULTS

Twenty-nine constructs were identified, including 16 psychological and 13 psychosocial constructs. The most frequently-reported constructs were work-related outcomes (32%), quality of life (31%), depression (30%), anxiety (18%), and fear (14%). Outcome measures consisted of validated and nonvalidated questionnaires and 1-item custom questions (including demographics). The number of different outcome measures used to assess an individual construct ranged between 1 (emotional distress) and 11 (quality of life) per construct.

CONCLUSION

There was a large variability in constructs and outcome measures reported in tendinopathy research, which limits conclusions about the relationship between psychological and psychosocial constructs, outcome measures, and tendinopathies. Given the wide range of psychological and psychosocial constructs reported, there is an urgent need to develop a core outcome set in tendinopathy. J Orthop Sports Phys Ther 2022;52(6):375-388. doi:10.2519/jospt.2022.11005.

Self-Reported Physical Demands Associated With Crops and Job Tasks Among Latinx Hired Child Farmworkers

OBJECTIVE

Physical demands of work performed by Latinx hired child farmworkers are poorly understood. This paper describes crops, tasks performed, and the most common dimensions of physical demands of work in this population.

METHODS

Survey interviews were conducted in 2017 with 202 Latinx children aged 10 to 17 years employed on North Carolina farms. Analysis focused on job characteristics for the past week and included factor analysis of an 18-item questionnaire on physical work demands.

RESULTS

The most common crops and tasks reported were topping/suckering tobacco and picking sweet potatoes or berries. Three factors (awkward postures, repetitive motion, strenuous work) accounted for 53% of the variance in physical demands.

CONCLUSIONS

Follow-up of hired child farmworkers should be undertaken to understand the long-term effects of physical work demands on their health.

Musculoskeletal injury symptoms among hired Latinx child farmworkers in North Carolina

BACKGROUND

Although children 10-17 years can be hired to work in agriculture, little research has addressed possible musculoskeletal injuries. Children may be at particular risk for these injuries because of the repetitive and load bearing nature of work tasks. Existing research relies on child workers to self-report musculoskeletal injuries.

METHODS

In 2017, 202 Latinx child farmworkers ages 10-17 employed across North Carolina completed survey interviews. In 2018, 145 of these children (94 [64.8%] current farmworkers) completed a physical examination and second interview. The examination obtained findings for upper and lower extremity as well as back injuries.

RESULTS

Positive indicators for musculoskeletal symptoms were few in either current or former child farmworkers. The knee was most common site for positive indicators with 15.4% of children having at least one. Combining all anatomical sites, 29.0% of children had at least one positive indicator, with no significant difference between current and former farmworkers. Overall, boys had significantly more indicators of knee injuries than girls (21.3% vs. 4.1%), indicators of ankle injuries were found only in the youngest workers (9.5% of children 11-13 years), and significantly fewer current farmworkers had indicators of lower back injuries than former farmworkers (6.4% vs. 17.7%).

CONCLUSIONS

Expectations of injuries come from previous studies using child farmworker self-reports, adult farmworker injury rates, and sports medicine pediatric findings. Hired child farmworkers may not perform activities as repetitious and load-bearing as children in sports training or adult farmworkers. Additional research using physical examination is needed to confirm these findings.

Latino/a Farmworkers' Concerns about Safety and Health in the Pennsylvania Mushroom Industry

The purposes of this study were to analyze Latino/a immigrant mushroom workers' perceptions of how the workplace environment shapes occupational safety and health, examine whether and how those perceptions differ by gender, and identify future areas for research on occupational safety and health in the mushroom industry. Researchers conducted structured interviews with 15 women and 45 men on 6 Pennsylvania mushroom farms to obtain their descriptions and perspectives of safety and health risk factors in their workplaces. Approximately one third of respondents had suffered an injury at work, and nearly half felt that there are workplace factors that affect their health and safety. The study found that Latino/a mushroom farmworkers perceive risks that are posed by the indoor infrastructure of mushroom production houses, including poorly maintained wooden walkways and cool indoor temperatures, and by the organization of mushroom production work, including the application of chemicals including pesticides, physical demands of the job, use of small knives, contact with compost, and the piece rate payment system. Workers commonly discussed back pain and believed it was associated with the organization of work. Women in the sample were more likely to be concerned about slips and falls than men and less likely to be concerned about aches and pains. Mushroom farm infrastructure and the specific demands of the jobs pose occupational safety and health risks to Latino/a farmworkers that merit further study to develop adequate public health interventions. Future research should obtain gender-disaggregated objective reports of injury, aches and pains, and discomfort and test for relationships between these reports and the indoor infrastructure and conditions of mushroom production work.

Environmental Health Threats to Latino Migrant Farmworkers

Approximately 75% of farmworkers in the United States are Latino migrants, and about 50% of hired farmworkers do not have authorization to work in the United States. Farmworkers face numerous chemical, physical, and biological threats to their health. The adverse effects of these hazards may be amplified among Latino migrant farmworkers, who are concurrently exposed to various psychosocial stressors. Factors such as documentation status, potential lack of authorization to work in the United States, and language and cultural barriers may also prevent Latino migrants from accessing federal aid, legal assistance, and health programs. These environmental, occupational, and social hazards may further exacerbate existing health disparities among US Latinos. This population is also likely to be disproportionately impacted by emerging threats, including climate change and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Latino migrant farmworkers are essential to agriculture in the United States, and actions are needed to protect this vulnerable population.

Common Upper Extremity Disorders and Function Affect Upper Extremity-Related Quality of Life: A Community-Based Sample from Rural Areas

PURPOSE

Upper extremity musculoskeletal disorders (UEMDs), such as rotator cuff tear, epicondylitis, and hand osteoarthritis, have a negative impact on quality of life (QOL). In this study, we evaluated the prevalence of rotator cuff tear, lateral and medial epicondylitis, and hand osteoarthritis in the dominant side and the impact of these UEMDs on the disabilities of the arm, shoulder, and hand (DASH) outcome measure, which assesses upper extremity-related QOL.

MATERIALS AND METHODS

In 2013-2015, 987 participants from rural areas completed a questionnaire and underwent physical examinations, laboratory tests, simple radiographic evaluations of bilateral upper extremities, and magnetic resonance imaging studies of bilateral shoulders. Based on data from these participants, researchers evaluated DASH and performed a functional assessment of each region of the dominant side and related UEMDs.

RESULTS

The prevalences of epicondylitis, rotator cuff tear, and hand osteoarthritis were 33.7%, 53.4%, and 44.6%, respectively. Univariate regression analysis results revealed that epicondylitis, epicondylitis+rotator cuff tear, epicondylitis+hand osteoarthritis, and epicondylitis+rotator cuff tear+hand osteoarthritis were significantly associated with DASH score. Multiple regression analysis, including DASH, UEMD, and regional functional assessments, showed that only epicondylitis and epicondylitis+rotator cuff tear were associated with DASH score.

CONCLUSION

Epicondylitis significantly affected QOL, while other UEMDs, such as hand osteoarthritis and rotator cuff tear, had no significant impact. When a patient's QOL is affected by a UEMD, there is an increased possibility of the simultaneous presence of other UEMDs.

Association of risk factors with musculoskeletal disorders in manual-working farmers

The current study is aimed at recognizing the risk factors for major work-related issues (ie, musculoskeletal disorders [MSDs]) among 138 manual-working farmers. Data were collected using modified Standardized Nordic Questionnaire and the Rapid Upper Limb Assessment score sheet. Different factors influencing MSDs were detected using logistic regression methods. The highest occurrence rate for MSDs was observed in the lower back (71.4%), followed by fingers (62.1%), shoulders (56.4%), and hands/wrists (55%). Factors such as age, gender, daily working hours, hand dominance, perceived fatigue, and work experience were found to be associated with MSDs in one or more upper body regions. The outcome of multinomial regression showed that gender is the most influencing factor for MSDs in all upper body regions except the shoulders. The outcomes of study indicate high occurrence of MSDs among manual-working farmers and highlight the significance of individual and work-related factors.

Optimizing implementation of interventions in agriculture for occupational upper extremity musculoskeletal disorders: Results of an expert panel

BACKGROUND

Upper extremity musculoskeletal disorders (UEMSD) is reported worldwide as the second-largest occupational musculoskeletal disorder in agriculture.

OBJECTIVE

The objective of the study is to identify facilitators and barriers for employers and workers for implementing interventions to reduce work-related risk factors associated with occupational UEMSD in the agricultural sector, according to health and safety consultants.

METHODS

An expert panel was used comprising nine health and safety consultants from the Dutch agricultural sector.

RESULTS

Facilitators and barriers for employers and workers were categorized in the following themes: knowledge, skills, attitude, culture, costs, loss of income, facilitation and employability. There were no differences in facilitators and barriers between UEMSD.

CONCLUSIONS

Facilitators and barriers for implementing preventive interventions in agriculture were on organizational level, like diversity in choice of preventive devices, and personal level such as willingness if there is no work disability.

A Descriptive Study of Body Pain and Work-Related Musculoskeletal Disorders Among Latino Farmworkers Working on Sweet Potato Farms in Eastern North Carolina

Agricultural work is a physically demanding occupation. The purpose of this project was to describe the prevalence of work-related musculoskeletal disorders (WMSDs) and self-reported pain among Latino farmworkers who work extensively hand harvesting sweet potatoes. Data were obtained from a cross-sectional survey of farmworkers (N = 120) in eastern North Carolina. Univariate and bivariate analyses were used to describe personal, work characteristics, and self-reported pain associated with musculoskeletal injuries. Overall, 79% of farmworkers reported any type of pain or discomfort. The highest reported areas of pain were in the back (66%) and shoulder areas (31%). Younger participants experienced more shoulder pain (P = .04) than older workers, and working more than 5 years as a farmworker was significantly associated with back pain (P = .01). Interventions aimed at administrative and engineering controls for reducing risk factors that contribute to WMSDs are warranted.

Musculoskeletal pain, depression, and stress among Latino manual laborers in North Carolina

The jobs of Latino manual laborers place their mental and physical health at risk. This study evaluates the associations among musculoskeletal pain, mental health, and work organization in Latino manual laborers. Farmworkers and nonfarmworkers (n = 189) in North Carolina were interviewed for self-reported musculoskeletal pain, depressive symptoms, stress, work safety climate, and precarious job status. More nonfarmworkers than farmworkers had neck and shoulder pain, but they did not differ in other areas of musculoskeletal pain. Depressive symptoms had a significant association with neck and shoulder pain (p < .05). Precariousness had a significant association with back pain (p < .05). Farmworker participants had H-2A visas and were afforded some protection compared to nonfarmworker manual workers. Research is needed to improve policy that relieves pain and improves mental health for all Latino manual workers.