Occupational risks and pregnancy and infant health outcomes in Florida farmworkers

The association between children's exposure to pesticides and asthma, wheezing, and lower respiratory tract infections. A systematic review and meta-analysis

Background

Exposure to pesticides is a global public health problem, especially for children. Its association with chronic respiratory disease among children has attracted considerable attention, but the existing evidence remains inconclusive and cannot be certain. Therefore, this systematic review and meta-analysis aim to determine the global pooled effect size of association with pesticide exposure and asthma, wheezing, and respiratory tract infections among children.

Methods

A comprehensive search was conducted for relevant literature from electronic databases, including PubMed, Google Scholar, Hinari, Semantic Scholar, and Science Direct. Studies that provided effect size on the association between pesticide exposure and childhood asthma, wheezing, and respiratory tract infections in children were included. The articles were screened, data was extracted, and the quality of each study was assessed with four independent reviewers. Random effects models for significant heterogeneity and fixed effect models for homogeneous studies were conducted to estimate pooled effect sizes with 95% confidence intervals using Comprehensive Meta-Analysis version 3.3.070 and MetaXL version 2. Funnel plot and Higgins I 2 statistics were used to determine the heterogeneity of the included studies. Subgroup analyses were computed based on the types of pesticide exposure, study design, sample size category, and outcome assessment technique.

Result

A total of 38 articles with 118,303 children less than 18 years of age were included in this meta-analysis. Pesticide exposure among children increased the risk of asthma by 24%; (OR = 1.24, 95% CI: 1.14-1.35) with extreme heterogeneity (I 2 = 81%, p < 0.001). Exposure to pesticides increased the odds of developing wheezing among children by 34% (OR = 1.34, 95% CI: 1.14-1.57), with high heterogeneity (I 2 = 79%, p < 0.001) and also increased the risk of developing lower respiratory tract infection by 79% (OR = 1.79, 95% CI: 1.45-2.21) with nonsignificant low heterogeneity (I 2 = 30%, p-value = 0.18).

Conclusion

This meta-analysis provided valuable evidence supporting the association between childhood asthma, wheezing, and lower respiratory tract infection with pesticide exposure. The findings would contribute to a better understanding of the estimate of the effect of pesticide exposure on respiratory health in children and inform evidence-based preventive strategies and public health interventions.

Ethylene thiourea exposure induces neurobehavioral toxicity in zebrafish by disrupting axon growth and neuromuscular junctions

Ethylene thiourea (ETU) converted from ethylene bisdithiocarbamate (EBDC) fungicides has aroused great concern because of its prevalence and harmful effects. Although ETU-induced neurotoxicity has been reported, the potential mechanisms remain unclear. This study provided insights into its neurotoxic effects at environmentally relevant concentrations in zebrafish. Our findings showed that embryonic exposure to ETU decreased the hatch rate and delayed somite development. Furthermore, ETU treatment significantly reduced the dark velocity in the locomotion assay. The upregulated tendency of the mitogen-activated protein kinases (MAPK) pathway (mknk1, atf4, mapkapk3) screened by transcriptome analysis implied motor neuron degeneration, which was validated by subsequent morphological observation, as axon length and branches were truncated in the 62.5 µg/L ETU group. However, although the rescue experiment with a p38 MAPK inhibitor (SB203580) successfully ameliorated axon degeneration, it failed to reverse the locomotion behaviors. Further exploration of transcriptome data revealed the varied expression of presynaptic scaffold protein-related genes (pcloa, pclob, bsna), whose downregulation might impair the neuromuscular junction (NMJ). Therefore, we reasonably suspected that ETU-induced neurobehavioral deficits might result from the combined effects of the MAPK pathway and presynaptic proteins. Considering this, we highlighted the necessity to take precautions and early interventions for susceptible ETU-exposed populations.

Respiratory and allergic health effects in children living near agriculture: A review

BACKGROUND

Exposure to pesticides and agricultural burning are likely to co-occur in agricultural communities, but these exposures have remained distinct bodies of research. We reviewed epidemiological studies to identify the respiratory health effects of children exposed to pesticides and agricultural burning through a systematic evaluation of peer-reviewed publications of children living in industrial agricultural areas.

METHODS

Two academic search databases (PubMed and Scopus) were queried for all available studies published in English before May 31st, 2021. The initial search combining both exposure metrics (pesticides and agricultural burning) yielded zero publications and thus the queries were performed and presented separately.

RESULTS

Studies were categorized based on main exposure of interest (i.e., pesticides or agricultural burning) and by respiratory health outcome assessment (i.e., self-reported asthma, acute respiratory symptoms, and lung function measurements). In total we identified 25 studies that focused on pesticide exposures and children's respiratory health, and 12 studies that focused on exposure to agricultural burning and children's respiratory health. A majority of the pesticide studies (18/25) reported a positive association between exposure to pesticides and adverse childhood respiratory health effects. Similarly, most (11/12) of the agricultural burning studies also reported a positive association between exposure to agricultural burning and adverse respiratory health effects.

CONCLUSION

The most frequently studied health outcomes in these publications were acute respiratory symptoms (n = 11 pesticides, n = 3 agricultural burning), followed by asthma (n = 9 pesticides, n = 3 agricultural burning), and lung function measurements (n = 5 pesticides, n = 6 agricultural burning). Although health outcome assessment differed between pesticide studies and agricultural burning studies, similar adverse respiratory health effects were observed across the majority of studies.

The Abysmal Organization of Work and Work Safety Culture Experienced by North Carolina Latinx Women in Farmworker Families

The occupational health of immigrant workers in the United States is a major concern. This analysis describes two domains, organization of work and work safety culture, important to the occupational health of Latinx women in farmworker families. Sixty-seven Latinx women in North Carolina farmworker families completed a baseline and five follow-up questionnaires in 2019 through 2021. Fifty-nine of the women were employed in the year prior to the Follow-Up 5 Questionnaire. These women experienced an abysmal organization of work and work safety culture. They experienced significant job churn, with most changing employment several times during the 18-month period. Most of their jobs were seasonal, paid less than $10.00 per hour, piece-rate, and almost all without benefits. The women's jobs had little skill variety (mean 1.5) or decision latitude (mean 1.1), but had high psychological demands (mean 2.0). Work safety climate was very low (mean 13.7), with 76.3% of women noting that their supervisors were "only interested in doing the job fast and cheaply" rather than safely. Women employed as farmworkers versus those in other jobs had few differences. Further research and intervention are needed on the organization of work and work safety culture of Latinx women manual workers.

The Challenges of Working in the Heat Whilst Pregnant: Insights From Gambian Women Farmers in the Face of Climate Change

Background

The expected increase in heat in The Gambia is one of the most significant health threats caused by climate change. However, little is known about the gendered dynamics of exposure and response to heat stress, including women's perceived health risks, their adaptation strategies to heat, and their perceptions of climate change. This research project aims to answer the question of whether and how pregnant farmers in The Gambia perceive and act upon occupational heat stress and its health impacts on both themselves and their unborn children, against the backdrop of current and expected climatic changes.

Method

In-depth semi-structured interviews were conducted with 12 women who practice subsistence farming and were either pregnant or had delivered within the past month in West Kiang, The Gambia. Participants were selected using purposive sampling. Translated interview transcripts were coded and qualitative thematic content analysis with an intersectional lens was used to arrive at the results.

Results

All women who participated in the study experience significant heat stress while working outdoors during pregnancy, with symptoms often including headache, dizziness, nausea, and chills. The most common adaptive techniques included resting in the shade while working, completing their work in multiple shorter time increments, taking medicine to reduce symptoms like headache, using water to cool down, and reducing the amount of area they cultivate. Layered identities, experiences, and household power structures related to age, migration, marital situation, socioeconomic status, and supportive social relationships shaped the extent to which women were able to prevent and reduce the effects of heat exposure during their work whilst pregnant. Women who participated in this study demonstrated high awareness of climate change and offered important insights into potential values, priorities, and mechanisms to enable effective adaptation.

Conclusion

Our findings reveal many intersecting social and economic factors that shape the space within which women can make decisions and take adaptive action to reduce the impact of heat during their pregnancy. To improve the health of pregnant working women exposed to heat, these intersectionalities must be considered when supporting women to adapt their working practices and cope with heat stress.

From Florence to fossil fuels: Nursing has always been about environmental health

BACKGROUND

Since its founding, professional nursing has applied an environmental lens to healing.

METHODS

This CANS 2020 Keynote article describes the history of nursing environmental science and nurses important contributions to the US Environmental Justice Movement. Starting with Florence Nightingale's Notes on Nursing, which established Environmental Theory, the paper introduces key figures throughout nursing history who have studied and advocated for environmental health and justice.

FINDINGS

The paper emphasizes that nursing has always been about environmental health and that, regardless of specialty or practice setting, all nurses are called to incorporate environmental science and translation into their research and practice.

CONCLUSION

This call to action is especially critical today in the context of urgent issues like climate change, environmental racism and racial health disparities, emerging infectious diseases like COVID-19, and chemical exposures in the home and workplace (among others).

Analyzing the predictors of health care utilization in the agricultural worker population using decision tree analysis: Does language matter?

OBJECTIVES

To analyze the predictors of health care utilization among respondents to the National Agricultural Worker Survey. Specifically, we hypothesized that English proficiency would predict utilization of health care services within the last 2 years.

METHODS

Using the 2015-2016 National Agricultural Worker Survey, we performed a secondary data analysis to analyze the predictors of health care utilization within the last 2 years in the United States' agricultural worker population. Data were cleaned and analyzed using decision tree analysis, which produced a classification tree model that was trained on 90% of the data and validated on 10%.

RESULTS

Exposure to English was not a predictor of health care utilization in our classification tree. The first major partition that predicted utilization was insurance status. Additional partitions were on age, gender, hypertension diagnosis, and public aid.

CONCLUSIONS

By partitioning on insurance status and use of public aid, the decision tree provided evidence that systemic factors are key determinants of health care utilization in the agricultural worker community. This highlights the importance of agencies that connect agricultural workers with resources that provide insurance and improve access to health care. This is especially important given that agricultural workers are one of the highest risk groups for occupational injury or death in the United States.

Respiratory and Allergic Effects in Children Exposed to Pesticides-A Systematic Review

Pesticide exposure may affect children’s respiratory and allergic health, although results from epidemiological studies have not reached consensus. This review aims to analyze the scientific evidence on respiratory and allergic effects of exposure to agricultural pesticides in children aged up to 12 years old. The databases PubMed, Web of Science, Scielo, and Lilacs were screened to select articles published in English, Spanish, or Portuguese, and 21 articles were included in this review. Most investigations were conducted in North America (mostly in the United States), while no studies conducted in Latin America or Africa were found, despite their intensive use of pesticides. Children are exposed to pesticides through multiple pathways from the prenatal period throughout later developmental stages and may experience several respiratory effects. Most studies (79%) found positive associations with pesticide exposure and children’s respiratory and allergic effects such as asthma, wheezing, coughs, acute respiratory infections, hay fever, rhinitis, eczema, chronic phlegm, and lung function impairments. Contrastingly, 21% of the studies found no associations between pesticide exposure and children’s respiratory health. The vast differences among the characteristics of the studies hamper any comparison of the results. Exposure to pesticides may have several impacts on childhood respiratory health. More studies must be conducted, especially in low- and middle-income countries, preferably with comparable research protocols adapted to local realities. Efforts should be made to develop comprehensive risk mitigation strategies and behavioral interventions to reduce children’s exposure to pesticides used in agriculture and respiratory health effects, and to ensure healthy childhood growth.

Predominant role of antioxidants in ameliorating the oxidative stress induced by pesticides

Oxidative stress has been reported as one of the adverse effects caused due to pesticides, which is the main mechanism of the toxicity in humans and animals and is a useful parameter in monitoring studies. It involves an imbalance in the equilibrium state of ROS and antioxidant defenses leading to alterations in various antioxidant enzyme levels and lipid peroxidation. The objective of the current paper is to present a review of the potential role and protective mechanism action of the antioxidant micronutrient supplementation to ameliorate the oxidative stress induced by pesticides. Studies in animal models and human were retrieved through the relevant search of the literature and categorized. Various animal studies were categorized according to the type of supplementation. Animal studies provide evidence to conclude the potential protective role of antioxidants in ameliorating the adverse effects of pesticides. Similar studies in humans are meager suggesting for further comprehensive research.

Utilisation of health services fails to meet the needs of pregnancy-related illnesses in rural southern Ethiopia: A prospective cohort study

Although maternal survival has improved in the last decades, evidence on illnesses and the use of health services during pregnancy remains scarce. Therefore, we aimed to assess the incidence and risk factors for illnesses among pregnant women and measure the use of health services. A prospective cohort study was conducted in three kebeles in rural southern Ethiopia among 794 pregnant women from May 2017 to July 2018. Each woman was followed every two weeks at home. Poisson and survival regression models were used for analysis. The incidence rate of episodes of illnesses was 93 per 100 pregnant-woman-weeks (95%CI: 90.6, 94.2), with an average of eight episodes of illnesses per woman. Anaemia accounted for 22% (177 of 794 women), and hypertension 3% (21 women of 794 women). However, utilization of health services for any illness episodes was only 8% (95%CI: 7.6%, 8.9%). The main reasons for not using health services were that the women thought the illness would heal by itself, women thought the illness was not serious, women could not afford to visit the health institutions, or women lacked confidence in the health institutions. The risk factors for illnesses are having many previous pregnancies in life time (ARR = 1.42; 95%CI = 1.02, 1.96), having history of stillbirth (ARR = 1.30; 95%CI = 1.03, 1.64), having history of abortion (AHR = 1.06; 95%CI = 1.02, 1.11), and walking more than 60 minutes to access the nearest hospital (AHR = 1.08; 95%CI = 1.03, 1.14). The risk factors for low use of health services are also having history of abortion (AHR = 2.50; 95%CI = 1.00, 6.01) and walking more than 60 minutes to access the nearest hospital (AHR = 1.91; 95%CI = 1.00, 3.63). Rural Ethiopian pregnant women experience a high burden of illness during pregnancy. Unfortunately, very few of these women utilize health services.

Mental Health Among Latina Farmworkers and Other Employed Latinas in North Carolina

The mental health of Latinas with manual occupations, particularly those employed in agriculture, is a public health concern. The goals of this analysis were to describe the mental health of Latina farmworkers, and to compare their mental health with that of other Latina manual workers. Participants included 35 employed Latina farmworkers, 35 employed non-farmworkers, and 25 unemployed non-farmworkers who completed interviews in 2012. Measures included stress, anxiety, depressive symptoms, elevated depressive symptoms, and risk for alcohol dependence. Farmworkers had greater stress and anxiety than did employed and unemployed non-farmworkers. Employed Latinas, whether farmworkers or in other occupations, had greater stress and anxiety than unemployed Latinas. Depressive symptoms, although high, did not differ significantly by occupation and employment. Few were at risk for alcohol dependence. Concrete steps are needed to address the mental health of Latina farmworkers, and to continue documentation of mental health concerns and their causes in this population.

Deleterious Effects From Occupational Exposure to Ethylene Thiourea in Pregnant Women

Human exposure to endocrine disrupting chemicals (EDCs) has become common as a result of widespread application of these chemicals to the food supply, environmental contamination, and occupational exposures (Caserta et al., 2011). However, relatively little is known about the effects of EDCs such as ethylene thiourea (ETU) in developing fetuses and the lasting implications of this disruption on human development from birth through adulthood. Of highest concern are chronic, low-dose exposures among industrial and agricultural workers. Current knowledge regarding the significance of endocrine thyroid signaling on normal human development raises serious concerns about the possible deleterious effects of EDCs in the developing fetus, children, and mature adults. Occupational health nurses are critical in identifying women and families at increased risk of ETU exposure and mitigating early exposures in pregnancy.

Collecting Comparative Data on Farmworker Housing and Health: Recommendations for Collecting Housing and Health Data Across Places and Time

The substandard nature of the housing in which most farmworkers live has detrimental effects on their health, as well as on their children's health and development. However, little research has directly documented associations between farmworker housing and health; existing research is not always comparable due to differences in design and measurement. Comparative data can help determine actual causal links between housing characteristics and farmworker health and help to evaluate the efficacy of current housing policy. The goal of this paper is to provide guidelines promoting comparable research on farmworker housing and the association of this housing with health. This paper reviews general concepts relevant to measuring farmworker housing and health, issues that should be considered in designing farmworker housing and health research, data collection methods, and measures. It concludes with recommendations for a research agenda on farmworker housing and health.