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Albu I, Elon L, Xiuhtecutli N, McCauley L, Chicas R. Retention of Agricultural Workers Participating in a Renal Longitudinal Study. J Agromedicine 2024; 29:26-33. [PMID: 37574800 PMCID: PMC10841276 DOI: 10.1080/1059924x.2023.2246966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
OBJECTIVES The relationship between heat stress, chronic kidney diseases and acute kidney injury has been documented in cross-sectional studies with agricultural workers. However, only a few international studies have assessed renal function in agricultural workers longitudinally. Our research study, Occupational Heat Exposure and Renal Dysfunction (OHEaRD) is the first longitudinal study in the U.S. that monitored renal function in agricultural workers five times over the course of 32-months. The main objectives of this study were to evaluate the rate of retention and identify predictors associated with retention in a longitudinal study with agricultural workers. METHODS In January 2020, we enrolled 119 Florida agricultural workers to observe on 5 workdays over 32 months. Retention was defined by the number of follow-up visits that a participant attended, the consistency of visit attendance, and attendance at the last visit. Participants were provided hemoglobin A1C, lipid panel, creatinine measurement, glomerular filtration rate (eGFR), blood pressure, and body mass index results and an incentive gift card were handed out to participants at each visit. RESULTS Four enrollees did not participate on any workday, thus analysis concentrated on the remaining 115 participants. The majority of participants (64%) completed the 32-month study, 78% completed at least 4 visits, and 55% completed all 5 visits. The statistically significant predictors of higher retention among this study were being older in age (p=0.02), Mexican nationality (p=0.004), working in ferneries (p=0.009), more years working in agriculture (p=0.02), and higher total cholesterol (p=0.02). Appreciation for the health tests was associated with greater participation at the final visit (p=0.01). CONCLUSION Retention in longitudinal studies is crucial to better understand kidney disease among agricultural workers, an understudied population. Participants reported valuing the access to health results, indicating that implementing point-of-care health screenings and providing the health results to each participant is a good retention strategy. There was some evidence that a participant living with or being related to a fellow co-participant could impact retention as they either showed up or missed visits together, suggesting recruiting from the same household may reduce retention.
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Affiliation(s)
- Ioana Albu
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Lisa Elon
- Rollins School of Public Health, Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA, USA
| | - Nezahualcoyotl Xiuhtecutli
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
- Farmworker Association of Florida, Apopka, FL, USA
| | - Linda McCauley
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Roxana Chicas
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
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Passos MHPD, Pícon SPB, Batista GDA, Nascimento VYS, Oliveira FADS, Locks F, Pitangui ACR, de Araújo RC. Effects of an eight-week physical exercise program on low back pain and function in fruit workers: A randomized controlled trial. J Back Musculoskelet Rehabil 2024; 37:733-742. [PMID: 38160342 DOI: 10.3233/bmr-230201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
BACKGROUND Low back pain is prevalent in workers' health and functional performance. OBJECTIVE To evaluate the effects of a physical exercise program on low back pain and disability in fruit workers. METHODS This randomized controlled trial assigned 44 workers (37 ± 9 years) to two groups. The experimental group consisted of 10 men and 12 women with an average age of 38 (± 9) years, and the control group consisted of 8 men and 14 women with an average age of 36 (± 10) years. The experimental group (EG) performed a program of strength and flexibility exercises for eight weeks, twice a week. The control group (CG) received minimal care, with a booklet with guidelines for performing exercises. The primary outcomes included changes in perceived disability and the intensity of pain evaluated by the Rolland-Morris questionnaire and the Numerical Pain Scale, respectively. All outcomes were measured at baseline and after eight weeks of intervention. RESULTS A significant difference was observed in the within-group analysis, with a mean reduction in pain intensity in the EG and CG of -4.55 (95%CI -7.01 to -2.09) and -3.81 (95%CI 1.72-5.90), respectively. For disability, a reduction of -4.45 (95% CI -8.89 to -0.02) was observed in the EG and of -4.43 (-7.38 to -1.48) in the CG. There were no significant differences in the between-groups analysis. CONCLUSIONS The exercise program was not superior to using the educational booklet. However, both interventions showed substantial decreases in pain and disability levels.
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Affiliation(s)
| | | | | | | | | | - Francisco Locks
- Graduate Program in Rehabilitation and Functional Performance, University of Pernambuco, Petrolina, Brazil
| | | | - Rodrigo Cappato de Araújo
- Associate Graduate Program in Physical Education, University of Pernambuco, Recife, Brazil
- Graduate Program in Rehabilitation and Functional Performance, University of Pernambuco, Petrolina, Brazil
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Petropoulos ZE, Keogh SA, Jarquín E, López-Pilarte D, Amador Velázquez JJ, García-Trabanino R, Amador Sánchez MR, Guevara R, Gruener A, Allen DR, Leibler JH, Delgado IS, McClean MD, Friedman DJ, Brooks DR, Scammell MK. Heat stress and heat strain among outdoor workers in El Salvador and Nicaragua. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2023; 33:622-630. [PMID: 37041408 PMCID: PMC10403352 DOI: 10.1038/s41370-023-00537-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 03/02/2023] [Accepted: 03/13/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND There is growing attention on occupational heat stress in Central America, as workers in this region are affected by a unique form of chronic kidney disease. Previous studies have examined wet bulb globe temperatures and estimated metabolic rates to assess heat stress, but there are limited data characterizing heat strain among these workers. OBJECTIVE The aims were to characterize heat stress and heat strain and examine whether job task, break duration, hydration practices, and kidney function were associated with heat strain. METHODS We used data from the MesoAmerican Nephropathy Occupational Study, a cohort of 569 outdoor workers in El Salvador and Nicaragua who underwent workplace exposure monitoring, including continuous measurement of core body temperature (Tc), heart rate (HR), physical activity, and wet bulb globe temperature (WBGT), over the course of three days in January 2018 - May 2018. Participants represented five industries: sugarcane, corn, plantain, brickmaking, and construction. RESULTS Median WBGTs were relatively high (>27 °C) at most sites, particularly when work shifts spanned the afternoon hours (e.g., 29.2 °C among plantain workers). Sugarcane workers, especially cane cutters in both countries and Nicaraguan agrichemical applicators, had the highest estimated metabolic rates (medians: 299-318 kcal/hr). Most workers spent little time on break (<10% of the shift), as determined by physical activity data. Overall, sugarcane workers-particularly those in Nicaragua-experienced the highest Tc and HR values. However, a few workers in other industries reached high Tc (>39 °C) as well. Impaired kidney function (estimated glomerular filtration rate <90 mL/min/1.73 m2) was associated with higher Tc and HR values, even after adjustment. SIGNIFICANCE This is the largest study to-date examining heat stress and strain among outdoor workers in Central America. Workers at sugar companies regularly experienced Tc > 38°C (76.9% of monitored person-days at Nicaraguan companies; 46.5% at Salvadoran companies). Workers with impaired kidney function had higher measures of Tc and HR. IMPACT STATEMENT This study examined levels of occupational heat stress and heat strain experienced among outdoor workers in five industries in El Salvador and Nicaragua. We characterized heat stress using wet bulb globe temperatures and estimated metabolic rate and heat strain using core body temperature and heart rate. Sugarcane workers, particularly cane cutters and Nicaraguan agrichemical applicators, performed more strenuous work and experienced greater levels of heat strain. Impaired kidney function was associated with higher heart rates and core body temperatures.
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Affiliation(s)
- Zoe E Petropoulos
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA.
| | - Sinead A Keogh
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Emmanuel Jarquín
- Agencia para el Desarrollo y la Salud Agropecuaria (AGDYSA), San Salvador, El Salvador
| | - Damaris López-Pilarte
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | | | - Ramón García-Trabanino
- Agencia para el Desarrollo y la Salud Agropecuaria (AGDYSA), San Salvador, El Salvador
- Centro de Hemodiálisis, San Salvador, El Salvador
- Emergency Social Fund for Health, Tierra Blanca, El Salvador
| | | | - Raúl Guevara
- Agencia para el Desarrollo y la Salud Agropecuaria (AGDYSA), San Salvador, El Salvador
| | - Alexa Gruener
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Dustin R Allen
- Department of Health Sciences, Boston University College of Health and Rehabilitation Sciences, Boston, MA, USA
| | - Jessica H Leibler
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Iris S Delgado
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Michael D McClean
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - David J Friedman
- Division of Nephrology, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Daniel R Brooks
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Madeleine K Scammell
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
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Marquez D, Krenz JE, Santos EC, Torres E, Palmández P, Sampson PD, Blancas M, Carmona J, Spector JT. The Effect of Participatory Heat Education on Agricultural Worker Knowledge. J Agromedicine 2023; 28:187-198. [PMID: 35345983 PMCID: PMC9573936 DOI: 10.1080/1059924x.2022.2058667] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Farmworkers disproportionately experience preventable adverse health effects from heat exposure. We sought to evaluate the effect of participatory heat education on farmworker knowledge. METHODS We conducted a parallel, comparison group intervention study to investigate the effectiveness of a Spanish/English participatory, culturally-tailored, heat education-based intervention on farmworker heat knowledge in the Summer 2019. We used convenience sampling to recruit adult outdoor farmworkers from Central/Eastern Washington State, USA. Crews were randomized to receive the intervention (n = 40 participants) versus not receive the intervention (n = 43 participants). We assessed changes in heat knowledge, scored on a scale from 0 to 11, between baseline, immediate post-intervention, and post-season, which was approximately three months after baseline, using the Wilcoxon signed-rank test. We compared differences in knowledge scores from baseline to post-season between groups using analysis of variance. RESULTS Average knowledge scores improved from 4.6 (standard deviation [sd] 1.5) to 6.3 (sd 2.0) pre to post season in the intervention group (p < 0.001). There was a greater improvement in pre-post knowledge scores in the intervention (average difference 1.6, sd 2.0) versus the comparison group (average difference 0.41, sd 1.7) (p = 0.04). CONCLUSIONS Participatory heat training was effective in improving farmworker heat knowledge over the course of a summer season. Results of this study will be used to guide heat prevention efforts for farmworkers. TRIAL REGISTRATION ClinicalTrials.gov Registration Number: NCT04234802.
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Affiliation(s)
- Diana Marquez
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Jennifer E. Krenz
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | | | - Elizabeth Torres
- Northwest Communities Education Center/Radio KDNA, Granger, WA, USA
| | - Pablo Palmández
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Paul D. Sampson
- Department of Statistics, University of Washington, Seattle, WA, USA
| | - Maria Blancas
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Jose Carmona
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - June T. Spector
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
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Chavez Santos E, Spector JT, Egbert J, Krenz J, Sampson PD, Palmández P, Torres E, Blancas M, Carmona J, Jung J, Flunker JC. The effect of the participatory heat education and awareness tools (HEAT) intervention on agricultural worker physiological heat strain: results from a parallel, comparison, group randomized study. BMC Public Health 2022; 22:1746. [PMID: 36104813 PMCID: PMC9476265 DOI: 10.1186/s12889-022-14144-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 09/06/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Farmworkers are at risk of heat-related illness (HRI). We sought to: 1) evaluate the effectiveness of farmworker Spanish/English participatory heat education and a supervisor decision-support mobile application (HEAT intervention) on physiological heat strain; and 2) describe factors associated with HRI symptoms reporting. METHODS We conducted a parallel, comparison group intervention study from May-September of 2019 in Central/Eastern Washington State, USA. We used convenience sampling to recruit adult outdoor farmworkers and allocated participating crews to intervention (n = 37 participants) and alternative-training comparison (n = 38 participants) groups. We measured heat strain monthly using heart rate and estimated core body temperature to compute the maximum work-shift physiological strain index (PSImax) and assessed self-reported HRI symptoms using a weekly survey. Multivariable linear mixed effects models were used to assess associations of the HEAT intervention with PSImax, and bivariate mixed models were used to describe factors associated with HRI symptoms reported (0, 1, 2+ symptoms), with random effects for workers. RESULTS We observed larger decreases in PSImax in the intervention versus comparison group for higher work exertion levels (categorized as low, low/medium-low, and high effort), after adjustment for maximum work-shift ambient Heat Index (HImax), but this was not statistically significant (interaction - 0.91 for high versus low/medium-low effort, t = - 1.60, p = 0.11). We observed a higher PSImax with high versus low/medium-low effort (main effect 1.96, t = 3.81, p < 0.001) and a lower PSImax with older age (- 0.03, t = - 2.95, p = 0.004), after covariate adjustment. There was no clear relationship between PSImax and the number of HRI symptoms reported. Reporting more symptoms was associated with older age, higher HImax, 10+ years agricultural work, not being an H-2A guest worker, and walking > 3 min to get to the toilet at work. CONCLUSIONS Effort level should be addressed in heat management plans, for example through work/rest cycles, rotation, and pacing, in addition to education and other factors that influence heat stress. Both symptoms and indicators of physiological heat strain should be monitored, if possible, during periods of high heat stress to increase the sensitivity of early HRI detection and prevention. Structural barriers to HRI prevention must also be addressed. TRIAL REGISTRATION ClinicalTrials.gov Registration Number: NCT04234802 , date first posted 21/01/2020.
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Affiliation(s)
- Erica Chavez Santos
- Department of Health Systems and Population Health, University of Washington, Seattle, WA, USA
| | - June T Spector
- Department of Environmental and Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, Seattle, WA, 98105, USA.
- Department of Medicine, University of Washington, 4225 Roosevelt Way NE, Seattle, WA, 98105, USA.
| | - Jared Egbert
- Department of Environmental and Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, Seattle, WA, 98105, USA
- Department of Preventive Medicine, Madigan Army Medical Center, Joint Base Lewis-McChord, Seattle, WA, USA
| | - Jennifer Krenz
- Department of Environmental and Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, Seattle, WA, 98105, USA
| | - Paul D Sampson
- Department of Statistics, University of Washington, Seattle, WA, USA
| | - Pablo Palmández
- Department of Environmental and Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, Seattle, WA, 98105, USA
| | - Elizabeth Torres
- Northwest Communities Education Center/Radio KDNA, Granger, WA, USA
| | - Maria Blancas
- Department of Environmental and Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, Seattle, WA, 98105, USA
| | - Jose Carmona
- Department of Environmental and Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, Seattle, WA, 98105, USA
| | - Jihoon Jung
- Department of Environmental and Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, Seattle, WA, 98105, USA
| | - John C Flunker
- Department of Environmental and Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, Seattle, WA, 98105, USA
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López-Carr D, Vanos J, Sánchez-Vargas A, Vargas R, Castillo F. Extreme Heat and COVID-19: A Dual Burden for Farmworkers. Front Public Health 2022; 10:884152. [PMID: 35602162 PMCID: PMC9114294 DOI: 10.3389/fpubh.2022.884152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 03/25/2022] [Indexed: 11/30/2022] Open
Abstract
Currently, there is an extensive literature examining heat impacts on labor productivity and health, as well as a recent surge in research around COVID-19. However, to our knowledge, no research to date examines the dual burden of COVID-19 and extreme heat on labor productivity and laborers' health and livelihoods. To close this research gap and shed light on a critical health and livelihood issue affecting a vulnerable population, we urge researchers to study the two topics in tandem. Because farmworkers have a high incidence of COVID-19 infections and a low rate of inoculation, they will be among those who suffer most from this dual burden. In this article, we discuss impacts from extreme heat and COVID-19 on farm laborers. We provide examples from the literature and a conceptual framework showing the bi-directional nature of heat impacts on COVID-19 and vice versa. We conclude with questions for further research and with specific policy recommendations to alleviate this dual burden. If implemented, these policies would enhance the wellbeing of farmworkers through improved unemployment benefits, updated regulations, and consistent implementation of outdoor labor regulations. Additionally, policies for farmworker-related health needs and cultural aspects of policy implementation and farmworker outreach are needed. These and related policies could potentially reduce the dual burden of COVID-19 and extreme heat impacts while future research explores their relative cost-effectiveness.
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Affiliation(s)
- David López-Carr
- Department of Geography, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Jennifer Vanos
- School of Sustainability, Arizona State University, Tempe, AZ, United States
| | - Armando Sánchez-Vargas
- Institute of Economic Research, National Autonomous University of Mexico, Mexico City, Mexico
| | - Río Vargas
- University of California, Berkeley, Berkeley, CA, United States
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Ioannou LG, Foster J, Morris NB, Piil JF, Havenith G, Mekjavic IB, Kenny GP, Nybo L, Flouris AD. Occupational heat strain in outdoor workers: A comprehensive review and meta-analysis. Temperature (Austin) 2022; 9:67-102. [PMID: 35655665 PMCID: PMC9154804 DOI: 10.1080/23328940.2022.2030634] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 01/11/2022] [Accepted: 01/13/2022] [Indexed: 12/29/2022] Open
Abstract
The present comprehensive review (i) summarizes the current knowledge on the impacts of occupational heat stress on outdoor workers, (ii) provides a historical background on this issue, (iii) presents a meta-analysis of published data, (iv) explores inter-individual and intra-individual factors, (v) discusses the available heat mitigation strategies, (vi) estimates physical work capacity, labour productivity, and metabolic rate for the year 2030, and (vii) provides an overview of existing policy and legal frameworks on occupational heat exposure. Meta-analytic findings from 38 field studies that involved monitoring 2,409 outdoor workers across 41 jobs in 21 countries suggest that occupational heat stress increases the core (r = 0.44) and skin (r = 0.44) temperatures, as well as the heart rate (r = 0.38) and urine specific gravity (r = 0.13) of outdoor workers (all p < 0.05). Moreover, it diminishes the capacity of outdoor workers for manual labour (r = -0.82; p < 0.001) and is responsible for more than two thirds of the reduction in their metabolic rate. Importantly, our analysis shows that physical work capacity is projected to be highly affected by the ongoing anthropogenic global warming. Nevertheless, the metabolic rate and, therefore, labour productivity are projected to remain at levels higher than the workers' physical work capacity, indicating that people will continue to work more intensely than they should to meet their financial obligations for food and shelter. In this respect, complementary measures targeting self-pacing, hydration, work-rest regimes, ventilated garments, and mechanization can be adopted to protect outdoor workers.
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Affiliation(s)
- Leonidas G. Ioannou
- FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - Josh Foster
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas and University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Nathan B. Morris
- Department of Human Physiology & Nutrition, University of Colorado, Springs, Colorado, USA
| | - Jacob F. Piil
- Department of Nutrition, Exercise and Sports, August Krogh Building, University of Copenhagen, Copenhagen, Denmark
| | - George Havenith
- Environmental Ergonomics Research Centre, Loughborough Design School, Loughborough University, Loughborough, UK
| | - Igor B. Mekjavic
- Department of Automation, Biocybernetics and Robotics, Jozef Stefan Institute, Ljubljana, Slovenia
| | - Glen P. Kenny
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Lars Nybo
- Department of Nutrition, Exercise and Sports, August Krogh Building, University of Copenhagen, Copenhagen, Denmark
| | - Andreas D. Flouris
- FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
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Kim Y, Kim J, Chicas R, Xiuhtecutli N, Matthews J, Zavanelli N, Kwon S, Lee SH, Hertzberg VS, Yeo W. Soft Wireless Bioelectronics Designed for Real-Time, Continuous Health Monitoring of Farmworkers. Adv Healthc Mater 2022; 11:e2200170. [PMID: 35306761 DOI: 10.1002/adhm.202200170] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 03/08/2022] [Indexed: 12/23/2022]
Abstract
Hotter summers caused by global warming and increased workload and duration are endangering the health of farmworkers, a high-risk population for heat-related illness (HRI), and deaths. Although prior studies using wearable sensors show the feasibility of employing field-collected data for HRI monitoring, existing devices still have limitations, such as data loss from motion artifacts, device discomfort from rigid electronics, difficulties with administering ingestible sensors, and low temporal resolution. Here, this paper introduces a wireless, wearable bioelectronic system with functionalities for continuous monitoring of skin temperature, electrocardiograms (ECG), heart rates (HR), and activities, configured in a single integrated package. Advanced nanomanufacturing based on laser machining allows rapid device fabrication and direct incorporation of sensors with a highly breathable substrate, allowing for managing excessive sweating and multimodal stresses. To validate the device's performance in agricultural settings, the device is applied to multiple farmworkers at various operations, including fernery, nursery, and crop. The accurate data recording, including high-fidelity ECG (signal-to-noise ratio: >20 dB), accurate HR (r = 0.89, r2 = 0.65 in linear correlation), and reliable temperature/activity, confirms the device's capability for multiparameter health monitoring of farmworkers.
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Affiliation(s)
- Yun‐Soung Kim
- George W. Woodruff School of Mechanical Engineering and IEN Center for Human‐Centric Interfaces and Engineering Georgia Institute of Technology Atlanta GA 30332 USA
| | - Jihoon Kim
- George W. Woodruff School of Mechanical Engineering and IEN Center for Human‐Centric Interfaces and Engineering Georgia Institute of Technology Atlanta GA 30332 USA
| | - Roxana Chicas
- Parker H. Petit Institute for Bioengineering and Biosciences Georgia Institute of Technology Atlanta GA 30332 USA
| | - Nezahualcoyotl Xiuhtecutli
- Farmworker Association of Florida Apopka FL 32703 USA
- Department of Anthropology Tulane University New Orleans LA 70118 USA
| | - Jared Matthews
- George W. Woodruff School of Mechanical Engineering and IEN Center for Human‐Centric Interfaces and Engineering Georgia Institute of Technology Atlanta GA 30332 USA
| | - Nathan Zavanelli
- George W. Woodruff School of Mechanical Engineering and IEN Center for Human‐Centric Interfaces and Engineering Georgia Institute of Technology Atlanta GA 30332 USA
| | - Shinjae Kwon
- George W. Woodruff School of Mechanical Engineering and IEN Center for Human‐Centric Interfaces and Engineering Georgia Institute of Technology Atlanta GA 30332 USA
| | - Sung Hoon Lee
- George W. Woodruff School of Mechanical Engineering and IEN Center for Human‐Centric Interfaces and Engineering Georgia Institute of Technology Atlanta GA 30332 USA
| | - Vicki S. Hertzberg
- Parker H. Petit Institute for Bioengineering and Biosciences Georgia Institute of Technology Atlanta GA 30332 USA
| | - Woon‐Hong Yeo
- George W. Woodruff School of Mechanical Engineering and IEN Center for Human‐Centric Interfaces and Engineering Georgia Institute of Technology Atlanta GA 30332 USA
- Parker H. Petit Institute for Bioengineering and Biosciences Georgia Institute of Technology Atlanta GA 30332 USA
- Wallace H. Coulter Department of Biomedical Engineering Georgia Tech and Emory University Atlanta GA 30332 USA
- Institute for Materials Georgia Institute of Technology Atlanta GA 30332 USA
- Neural Engineering Center Georgia Institute of Technology Atlanta GA 30332 USA
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9
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Egbert J, Krenz J, Sampson PD, Jung J, Calkins M, Zhang K, Palmández P, Faestel P, Spector JT. Accuracy of an estimated core temperature algorithm for agricultural workers. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2022; 77:809-818. [PMID: 35114899 PMCID: PMC9346099 DOI: 10.1080/19338244.2022.2033672] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
There is a substantial burden of occupational health effects from heat exposure. We sought to assess the accuracy of estimated core body temperature (CBTest) derived from an algorithm that uses sequential heart rate and initializing CBT,1 compared with gastrointestinal temperature measured using more invasive ingestible sensors (CBTgi), among outdoor agricultural workers. We analyzed CBTest and CBTgi data from Washington State, USA, pear and apple harvesters collected across one work shift in 2015 (13,413 observations, 35 participants) using Bland Altman methods. The mean (standard deviation, range) CBTgi was 37.7 (0.4, 36.5-39.4)°C. Overall CBT bias (limits of agreement) was -0.14 (±0.76)°C. Biases ranged from -0.006 to -0.75 °C. The algorithm, which does not require the use of ingestible sensors, may be a practical tool in research among groups of workers for evaluating the effectiveness of interventions to prevent adverse occupational heat health effects.
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Affiliation(s)
- Jared Egbert
- Department of Preventive Medicine, Madigan Army Medical Center, Joint Base Lewis-McChord, WA, USA
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Jennifer Krenz
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Paul D. Sampson
- Department of Statistics, University of Washington, Seattle, WA, USA
| | - Jihoon Jung
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Miriam Calkins
- Division of Field Studies and Engineering - Field Research Branch, National Institute for Occupational Safety & Health, Centers for Disease Control and Prevention, Cincinnati, OH, USA
| | - Kai Zhang
- Department of Environmental Health Sciences, University of Albany, State University of New York, Albany, NY, USA
| | - Pablo Palmández
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Paul Faestel
- Department of Preventive Medicine, Madigan Army Medical Center, Joint Base Lewis-McChord, WA, USA
| | - June T. Spector
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
- Department of Medicine, University of Washington, Seattle, WA, USA
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