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Claudel SE, Chan M, Scammell MK, Waikar SS. Challenges and Opportunities: Studying CKDu in the United States. KIDNEY360 2024; 5:02200512-990000000-00352. [PMID: 38446084 DOI: 10.34067/kid.0000000000000408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 02/26/2024] [Indexed: 03/07/2024]
Affiliation(s)
- Sophie E Claudel
- Department of Medicine, Boston Medical Center and Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Maya Chan
- Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Madeleine K Scammell
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Sushrut S Waikar
- Section of Nephrology, Department of Medicine, Boston Medical Center and Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
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2
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Ahdoot S, Baum CR, Cataletto MB, Hogan P, Wu CB, Bernstein A. Climate Change and Children's Health: Building a Healthy Future for Every Child. Pediatrics 2024; 153:e2023065504. [PMID: 38374809 DOI: 10.1542/peds.2023-065504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/19/2023] [Indexed: 02/21/2024] Open
Abstract
The warming of our planet matters to every child. Driven by fossil fuel-generated greenhouse gas emissions, climate conditions stable since the founding of modern pediatrics in the mid-nineteenth century have shifted, and old certainties are falling away. Children's physical and mental health are threatened by climate change through its effects on temperature, precipitation, and extreme weather; ecological disruption; and community disruption. These impacts expose and amplify existing inequities and create unprecedented intergenerational injustice. Fossil fuel extraction and combustion cause harm today and reach centuries into the future, jeopardizing the health, safety, and prosperity of today's children and future generations. Appreciating the unique vulnerability of their patients, pediatricians have become leading health advocates for climate actions necessary to protect all living and future children. Policies that reduce reliance on fossil fuels and promote cleaner air, facilitate walking and bicycling, encourage more sustainable diets, increase access to nature, and develop more connected communities lead to immediate gains in child health and equity, and build a foundation for generations of children to thrive.
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Affiliation(s)
- Samantha Ahdoot
- University of Virginia School of Medicine, Charlottesville, Virginia
| | - Carl R Baum
- Section of Pediatric Emergency Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Mary Bono Cataletto
- Division of Pediatric Pulmonology and Sleep Medicine, Department of Pediatrics, New York University Long Island School of Medicine, Mineola, New York
| | - Patrick Hogan
- Pediatric Residency Program, Oregon Health & Science University, Portland, Oregon
| | - Christina B Wu
- O'Neill Center for Global and National Health Law, Georgetown University Law Center, Washington, District of Columbia
| | - Aaron Bernstein
- Division of General Pediatrics, Boston Children's Hospital, and Center for Climate, Health, and the Global Environment, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Ahdoot S, Baum CR, Cataletto MB, Hogan P, Wu CB, Bernstein A. Climate Change and Children's Health: Building a Healthy Future for Every Child. Pediatrics 2024; 153:e2023065505. [PMID: 38374808 DOI: 10.1542/peds.2023-065505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/19/2023] [Indexed: 02/21/2024] Open
Abstract
Observed changes in temperature, precipitation patterns, sea level, and extreme weather are destabilizing major determinants of human health. Children are at higher risk of climate-related health burdens than adults because of their unique behavior patterns; developing organ systems and physiology; greater exposure to air, food, and water contaminants per unit of body weight; and dependence on caregivers. Climate change harms children through numerous pathways, including air pollution, heat exposure, floods and hurricanes, food insecurity and nutrition, changing epidemiology of infections, and mental health harms. As the planet continues to warm, climate change's impacts will worsen, threatening to define the health and welfare of children at every stage of their lives. Children who already bear higher burden of disease because of living in low-wealth households and communities, lack of access to high quality education, and experiencing racism and other forms of unjust discrimination bear greater risk of suffering from climate change hazards. Climate change solutions, advanced through collaborative work of pediatricians, health systems, communities, corporations, and governments lead to immediate gains in child health and equity and build a foundation for generations of children to thrive. This technical report reviews the nature of climate change and its associated child health effects and supports the recommendations in the accompanying policy statement on climate change and children's health.
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Affiliation(s)
- Samantha Ahdoot
- University of Virginia School of Medicine, Charlottesville, Virginia
| | - Carl R Baum
- Section of Pediatric Emergency Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Mary Bono Cataletto
- Division of Pediatric Pulmonology and Sleep Medicine, Department of Pediatrics, New York University Long Island School of Medicine, Mineola, New York
| | - Patrick Hogan
- Pediatric Residency Program, Oregon Health & Science University, Portland, Oregon
| | - Christina B Wu
- O'Neill Center for Global and National Health Law, Georgetown University Law Center, Washington, District of Columbia
| | - Aaron Bernstein
- Division of General Pediatrics, Boston Children's Hospital, and Center for Climate, Health, and the Global Environment, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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4
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Arnold TJ, Arcury TA, Quandt SA, Sandberg JC, Talton JW, Daniel SS. Understanding Latinx Child Farmworkers' Reasons for Working: A Mixed Methods Approach. JOURNAL OF ADOLESCENT RESEARCH 2023; 38:1142-1176. [PMID: 38235371 PMCID: PMC10794015 DOI: 10.1177/07435584221144956] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
Agricultural labor is extremely hazardous, yet young children are legally permitted to work on farms. This paper contextualizes and describes Latinx hired child farmworkers’ stated reasons for working. We conducted a mixed-methods study using in-depth interviews ( n = 30) and survey interviews ( n = 202) with Latinx child farmworkers aged 10 to 17 in North Carolina. Our qualitative thematic analysis identified children’s salient reasons for working, including supporting family, contextual factors that lead to farm work, and occupying summer time. Statistical analysis showed that children’s primary reasons for working included buying clothes (91.1%) and school supplies (64.7%), with few differences by gender, age, or other characteristics. The findings demonstrate that most Latinx children view farm work as a necessary but temporary experience that financially supports their families. We discuss the implications for protecting Latinx child workers by reducing their structural vulnerability in order to facilitate healthy development.
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Affiliation(s)
- Taylor J. Arnold
- Department of Family and Community Medicine, Wake Forest University School of Medicine
| | - Thomas A. Arcury
- Department of Family and Community Medicine, Wake Forest University School of Medicine
| | - Sara A. Quandt
- Department of Epidemiology and Prevention, Wake Forest University School of Medicine
| | - Joanne C. Sandberg
- Department of Family and Community Medicine, Wake Forest University School of Medicine
| | - Jennifer W. Talton
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine
| | - Stephanie S. Daniel
- Department of Family and Community Medicine, Wake Forest University School of Medicine
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5
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Bozdag F, Balci S. Prevalence of musculoskeletal system problems in children working in Turkey's automotive industry. Public Health Nurs 2023; 40:876-884. [PMID: 37572346 DOI: 10.1111/phn.13243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 07/31/2023] [Accepted: 08/01/2023] [Indexed: 08/14/2023]
Abstract
OBJECTIVE This epidemiology study was conducted to determine the musculoskeletal system problems of children working in the automotive industry and related factors affecting them in the province of Şanlıurfa, the Turkish province where the child population is the highest at 44.9%. DESIGN AND METHODS A cross-sectional descriptive type study of 256 children aged 7-17 years working in Şanlıurfa Evren Auto Industry Site and Birecik Fırat Auto Industry Site was carried out between April and September 2021. RESULTS The majority (55.9%) of the children spent most of their time afoot while working and had musculoskeletal symptoms, with a duration of more than one year. The body areas with the most symptoms were the waist, feet, and hands, respectively. These symptoms had not occurred before a child started working and were affected by the posture they worked in, and their daily working and sleep hours. CONCLUSION Public health nurses are in a position to ensure that tetanus vaccination of working children, employment examinations, routine health checks, and necessary personal protective equipment are available. They can also work to ensure that children work for legal periods, get paid their wages, have health insurance, receive apprenticeship training, and only start working when they reach the age of being an apprentice or apprentice candidate.
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Affiliation(s)
- Fatma Bozdag
- Health Sciences of Faculty -Department of Child Health and Diseases Nursing, Harran University, Sanlıurfa, Turkey
| | - Serap Balci
- Florence Nightingale Faculty of Nursing -Department of Child Health and Diseases Nursing, Istanbul University-Cerrahpasa, Istanbul, Turkey
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6
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Carlos Chavez FL, Moore BA, Bohanek JG. Latino Migrant Farmworker Youths' Perceptions of Access to Care in the Southeast: A Qualitative Approach. J Agromedicine 2023; 28:821-839. [PMID: 37198942 DOI: 10.1080/1059924x.2023.2215753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
This study explored Latino Migrant Farmworker (LMFW) youths' perceptions regarding access to health care in the United States (U.S.). Twenty semi-structured audio-voice recorded interviews were conducted with LMFW youths (aged 15-20 years old) in Georgia and Florida. Thematic analysis was used to explore whether, and how, LMFW youths would seek health care in the U.S. as well as their personal views toward health care. Five distinct perceptions regarding accessing health care were delineated: (1) cultural-related views and attitudes toward health care, (2) transportation dependency, (3) English language as a barrier for communication, (4) lack of knowledge of available resources, and (5) embracing the obligation, and the necessity, of work. Some of LMFW youths' perceptions of seeking access to health care in the U.S. point to barriers related to social determinants of health. These barriers suggest the need for significant reform within the U.S. health care system to include farmworker youths' health needs and to promote cultural responsiveness among clinicians and rural health providers to better serve this vulnerable population.
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Affiliation(s)
- Fiorella L Carlos Chavez
- Edson College of Nursing and Health Innovation, The Center for Health Promotion and Disease Prevention, Arizona State University, Phoenix, AZ, USA
| | - Bethany A Moore
- Harry S Truman School of Public Affairs, College of Arts and Sciences, University of Missouri, Columbia, MO, USA
| | - Jennifer G Bohanek
- Department of Psychological Sciences, University of Missouri, Columbia, MO, USA
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7
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Iannacci-Manasia L. Unprotected Youth Workers in US Agriculture. Front Public Health 2023; 11:1064143. [PMID: 37325300 PMCID: PMC10268000 DOI: 10.3389/fpubh.2023.1064143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 01/24/2023] [Indexed: 06/17/2023] Open
Affiliation(s)
- Lisa Iannacci-Manasia
- School of Nursing, Columbia University, New York, NY, United States
- School of Nursing, Molloy University, Rockville Centre, NY, United States
- Department of the Sciences of Public Health, Nursing & Pediatrics, University of Turin, Piedmont, Italy
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8
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Peden AE, Tran TP, Alonzo D, Hawke C, Franklin RC. Adolescence is an opportunity for farm injury prevention: A call for better age-based data disaggregation. Front Public Health 2022; 10:1036657. [PMID: 36339219 PMCID: PMC9631027 DOI: 10.3389/fpubh.2022.1036657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 10/04/2022] [Indexed: 01/29/2023] Open
Affiliation(s)
- Amy E. Peden
- School of Population Health, UNSW Sydney, Kensington, NSW, Australia,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia,*Correspondence: Amy E. Peden
| | - Tich Phuoc Tran
- School of Science, University of New South Wales, Canberra, ACT, Australia
| | - Dennis Alonzo
- School of Education, UNSW Sydney, Kensington, NSW, Australia
| | - Catherine Hawke
- School of Rural Health, University of Sydney, Orange, NSW, Australia
| | - Richard C. Franklin
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia
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Berberian AG, Gonzalez DJX, Cushing LJ. Racial Disparities in Climate Change-Related Health Effects in the United States. Curr Environ Health Rep 2022; 9:451-464. [PMID: 35633370 PMCID: PMC9363288 DOI: 10.1007/s40572-022-00360-w] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE OF REVIEW Climate change is causing warming over most parts of the USA and more extreme weather events. The health impacts of these changes are not experienced equally. We synthesize the recent evidence that climatic changes linked to global warming are having a disparate impact on the health of people of color, including children. RECENT FINDINGS Multiple studies of heat, extreme cold, hurricanes, flooding, and wildfires find evidence that people of color, including Black, Latinx, Native American, Pacific Islander, and Asian communities are at higher risk of climate-related health impacts than Whites, although this is not always the case. Studies of adults have found evidence of racial disparities related to climatic changes with respect to mortality, respiratory and cardiovascular disease, mental health, and heat-related illness. Children are particularly vulnerable to the health impacts of climate change, and infants and children of color have experienced adverse perinatal outcomes, occupational heat stress, and increases in emergency department visits associated with extreme weather. The evidence strongly suggests climate change is an environmental injustice that is likely to exacerbate existing racial disparities across a broad range of health outcomes.
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Affiliation(s)
- Alique G Berberian
- Department of Environmental Health Sciences, University of California, 650 Charles E. Young Drive South, 71-259 CHS, Los Angeles, CA, 90095, USA
| | - David J X Gonzalez
- School of Public Health and Department of Environmental Science, Policy, and Management, University of California, Berkeley, CA, USA
| | - Lara J Cushing
- Department of Environmental Health Sciences, University of California, 650 Charles E. Young Drive South, 71-259 CHS, Los Angeles, CA, 90095, USA.
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El Khayat M, Halwani DA, Hneiny L, Alameddine I, Haidar MA, Habib RR. Impacts of Climate Change and Heat Stress on Farmworkers' Health: A Scoping Review. Front Public Health 2022; 10:782811. [PMID: 35211437 PMCID: PMC8861180 DOI: 10.3389/fpubh.2022.782811] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 01/10/2022] [Indexed: 01/27/2023] Open
Abstract
Due to the continuous rise of global temperatures and heatwaves worldwide as a result of climate change, concerns for the health and safety of working populations have increased. Workers in the food production chain, particularly farmworkers, are especially vulnerable to heat stress due to the strenuous nature of their work, which is performed primarily outdoors under poor working conditions. At the cross-section of climate change and farmworkers' health, a scoping review was undertaken to summarize the existing knowledge regarding the health impacts associated with climate change and heat stress, guide future research toward better understanding current and future climate change risks, and inform policies to protect the health and safety of agricultural workers. A systematic search of 5 electronic databases and gray literature websites was conducted to identify relevant literature published up until December 2021. A total of 9045 records were retrieved from the searches, of which 92 articles were included in the final review. The majority of the reviewed articles focused on heat-related illnesses (n = 57) and kidney diseases (n = 28). The risk factors identified in the reviewed studies included gender, dehydration, heat strain, wearing inappropriate clothing, workload, piece-rate payment, job decision latitude, and hot environmental conditions. On the other hand, various protective and preventive factors were identified including drinking water, changing work hours and schedule of activities, wearing appropriate clothing, reducing soda consumption, taking breaks in shaded or air-conditioned areas, and increasing electrolyte consumption in addition to improving access to medical care. This review also identified various factors that are unique to vulnerable agricultural populations, including migrant and child farmworkers. Our findings call for an urgent need to expand future research on vulnerable agricultural communities including migrant workers so as to develop effective policies and interventions that can protect these communities from the effects of heat stress.
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Affiliation(s)
- Moussa El Khayat
- Department of Environmental Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Dana A. Halwani
- Department of Environmental Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Layal Hneiny
- Saab Medical Library, American University of Beirut, Beirut, Lebanon
| | - Ibrahim Alameddine
- Department of Civil and Environmental Engineering, Maroun Semaan Faculty of Engineering and Architecture, American University of Beirut, Beirut, Lebanon
| | - Mustapha A. Haidar
- Department of Agriculture, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Rima R. Habib
- Department of Environmental Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
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Quandt SA, Arnold TJ, Arcury TA, Talton JW, Daniel SS. Self-Reported Physical Demands Associated With Crops and Job Tasks Among Latinx Hired Child Farmworkers. J Occup Environ Med 2021; 63:e838-e845. [PMID: 34860206 PMCID: PMC8646954 DOI: 10.1097/jom.0000000000002322] [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: 11/26/2022]
Abstract
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.
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Affiliation(s)
- Sara A. Quandt
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, USA
| | - Taylor J. Arnold
- Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, USA
| | - Thomas A. Arcury
- Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, USA
| | - Jennifer W. Talton
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, USA
| | - Stephanie S. Daniel
- Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, USA
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Habib RR, Mikati D, Al-Barathie J, Abi Younes E, Jawad M, El Asmar K, Ziadee M. Work-related injuries among Syrian refugee child workers in the Bekaa Valley of Lebanon: A gender-sensitive analysis. PLoS One 2021; 16:e0257330. [PMID: 34543313 PMCID: PMC8452013 DOI: 10.1371/journal.pone.0257330] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 08/27/2021] [Indexed: 11/21/2022] Open
Abstract
Background Syrian refugees in Lebanon have endured increasing hardships since the onset of the Syrian war in 2011, with many resorting to child labor. Working refugee children endure socioeconomic deprivation and harsh working conditions. This study explores the relationship between working conditions and the reporting of injuries among male and female Syrian refugee children in Lebanon and the related gender differences. Methods and findings A cross-sectional survey of Syrian refugee children working in the Bekaa Valley of Lebanon was conducted in 2017. Face-to-face interviews with children (8 to 18 years) collected sociodemographic information and testimonies of their work experiences. Logistic regression tested the association between reporting of injuries and risk factors including school enrolment, field of work, means of transportation to work, age started working, number of working hours, multiple jobs, work pressure and hazards, and abuse. Analyses were stratified by gender. Of the 4090 surveyed working children, the majority reported working in agriculture (75.8%). Around a third (31.4%) reported being injured at work with a higher proportion in males. The most common reported injuries were cuts and wounds (44.9%), with males showing a higher proportion for all types of injuries compared to females. Nearly one fifth of reported injuries (19.8%) required medical attention in a hospital, with males reporting higher proportions than females for most types of injuries. The study findings revealed the association of multiple risk factors with an increased odds of reporting an injury, which included working in more than one job (AOR, 1.71; CI, 1.20–2.43; p = 0.003), working under pressure (AOR, 1.64; CI, 1.36–1.97; p<0.001), the use of sharp or heavy objects (AOR, 1.88; CI, 1.58–2.24; p<0.001), and experiencing physical abuse at work (AOR, 2.46; CI, 1.97–3.08; p<0.001). The odds of reporting an injury increased with every additional hour of work per day (AOR 1.08; CI, 1.02–1.14; p = 0.006). Most of these findings persisted in the male and female stratified models, with few exceptions. Males who went to work in a pickup truck had significantly lower odds of being injured than those who walked (AOR, 0.65; CI, 0.51–0.83; p = 0.001); this finding did not reach significance for females. Having longer work hours per day was significantly linked to higher odds of injury for females (AOR, 1.07; CI, 1.02–1.12; p = 0.008); but not for males. The main limitations of this study were its cross-sectional design and the use of self-reported variables. Conclusions This study is the first to obtain direct testimony on work-related injuries and working conditions, exploring gender differences, among Syrian refugee children in Lebanon. Results demonstrated the association between the occurrence of injury and multiple risk factors highlighting their strenuous working conditions, with some differences detected between males and females. Many injuries can be prevented through direct safety interventions and proper implementation of child labor policies. Multidimensional interventions are essential to address the complex evolving challenges facing refugees.
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Affiliation(s)
- Rima R. Habib
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
- * E-mail:
| | - Diana Mikati
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | | | - Elio Abi Younes
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Mohammed Jawad
- Public Health Policy Evaluation Unit, Imperial College London, London, United Kingdom
| | - Khalil El Asmar
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Micheline Ziadee
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
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Arnold TJ, Arcury TA, Quandt SA, Mora DC, Daniel SS. Structural Vulnerability and Occupational Injury Among Latinx Child Farmworkers in North Carolina. New Solut 2021; 31:125-140. [PMID: 33982609 PMCID: PMC9075681 DOI: 10.1177/10482911211017556] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Children as young as ten-years-old can legally work as hired farm labor in the United States. In North Carolina, many hired children are part of the Latinx farmworker community. Agriculture is a hazardous industry, and child workers experience high rates of injury, illness, and mortality. As part of a community-based participatory research study, we draw from thirty in-depth interviews with Latinx child farmworkers aged ten to seventeen to describe their experiences of personal and observed workplace injury and close calls. Nearly all child workers had experienced or observed some form of injury, with several reporting close calls that could have resulted in severe injury or fatality. Overall, children reported a reactive approach to injury prevention and normalized pain as part of the job. Highlighting Latinx child farmworkers' structural "vulnerability, this analysis contextualizes understanding of workplace injury among this largely hidden population. We offer policy recommendations to protect and support these vulnerable workers.
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Affiliation(s)
- Taylor J. Arnold
- Department of Family and Community Medicine—Research, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Thomas A. Arcury
- Department of Family and Community Medicine—Research, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Sara A. Quandt
- Department of Epidemiology, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Dana C. Mora
- Faculty of Health Sciences, UiT The Arctic University of Norway, Tromso, Norway
| | - Stephanie S. Daniel
- Department of Family and Community Medicine—Research, Wake Forest School of Medicine, Winston-Salem, NC, USA
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14
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Arcury TA, Chen H, Arnold TJ, Quandt SA, Anderson KA, Scott RP, Talton JW, Daniel SS. Pesticide exposure among Latinx child farmworkers in North Carolina. Am J Ind Med 2021; 64:602-619. [PMID: 34036619 DOI: 10.1002/ajim.23258] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/06/2021] [Accepted: 05/06/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND Although pesticides have adverse effects on child health and development, little research has examined pesticide exposure among child farmworkers. This analysis addresses two specific aims: (1) describes pesticide exposure among Latinx child farmworkers in North Carolina, and (2) delineates factors associated with this pesticide exposure. METHODS In 2018 (n = 173) and 2019 (n = 156) Latinx child farmworkers completed interviews and wore silicone wristbands for a single day to measure pesticide exposure. Wristbands were analyzed for 70 pesticides. RESULTS Most Latinx child farmworkers were exposed to multiple pesticides; the most frequent were pyrethroids (69.9% in 2018, 67.9% in 2019), organochlorines (51.4% in 2018, 55.1% in 2019), and organophosphates (51.4% in 2018, 34.0% in 2019). Children were exposed to a mean of 2.15 pesticide classes in 2018 and 1.91 in 2019, and to a mean of 4.06 pesticides in 2018 and 3.34 in 2019. Younger children (≤15 years) had more detections than older children; children not currently engaged in farm work had more detections than children currently engaged in farm work. Migrant child farmworkers had more detections than nonmigrants. For specific pesticides with at least 20 detections, detections and concentrations were generally greater among children not currently engaged in farm work than children currently engaged. CONCLUSIONS Children who live in farmworker communities are exposed to a plethora of pesticides. Although further research is needed to document the extent of pesticide exposure and its health consequences, sufficient information is available to inform the policy needed to eliminate this pesticide exposure in agricultural communities.
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Affiliation(s)
- Thomas A. Arcury
- Department of Family and Community Medicine Wake Forest School of Medicine Winston‐Salem North Carolina USA
- Center for Worker Health Wake Forest School of Medicine Winston‐Salem North Carolina USA
| | - Haiying Chen
- Center for Worker Health Wake Forest School of Medicine Winston‐Salem North Carolina USA
- Department of Biostatistics and Data Science, Division of Public Health Sciences Wake Forest School of Medicine Winston‐Salem North Carolina USA
| | - Taylor J. Arnold
- Department of Family and Community Medicine Wake Forest School of Medicine Winston‐Salem North Carolina USA
| | - Sara A. Quandt
- Center for Worker Health Wake Forest School of Medicine Winston‐Salem North Carolina USA
- Department of Epidemiology and Prevention, Division of Public Health Sciences Wake Forest School of Medicine Winston‐Salem North Carolina USA
| | - Kim A. Anderson
- Department of Environmental and Molecular Toxicology Oregon State University Corvallis Oregon USA
| | - Richard P. Scott
- Department of Environmental and Molecular Toxicology Oregon State University Corvallis Oregon USA
| | - Jennifer W. Talton
- Department of Biostatistics and Data Science, Division of Public Health Sciences Wake Forest School of Medicine Winston‐Salem North Carolina USA
| | - Stephanie S. Daniel
- Department of Family and Community Medicine Wake Forest School of Medicine Winston‐Salem North Carolina USA
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Quandt SA, Arnold TJ, Talton JW, Miles CM, Mora DC, Arcury TA, Daniel SS. Musculoskeletal injury symptoms among hired Latinx child farmworkers in North Carolina. Am J Ind Med 2021; 64:620-628. [PMID: 34002867 DOI: 10.1002/ajim.23255] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/26/2021] [Accepted: 05/03/2021] [Indexed: 01/18/2023]
Abstract
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.
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Affiliation(s)
- Sara A. Quandt
- Department of Epidemiology and Prevention, Division of Public Health Sciences Wake Forest School of Medicine Winston‐Salem North Carolina USA
| | - Taylor J. Arnold
- Department of Family and Community Medicine Wake Forest School of Medicine Winston‐Salem North Carolina USA
| | - Jennifer W. Talton
- Department of Biostatistics and Data Science, Division of Public Health Sciences Wake Forest School of Medicine Winston‐Salem North Carolina USA
| | - Christopher M. Miles
- Department of Family and Community Medicine Wake Forest School of Medicine Winston‐Salem North Carolina USA
| | - Dana C. Mora
- Department of Family and Community Medicine Wake Forest School of Medicine Winston‐Salem North Carolina USA
- Department of Community Medicine, National Research Center in Complementary and Alternative Medicine, NAFKAM, Faculty of Health Science UiT The Arctic University of Norway Tromsø Norway
| | - Thomas A. Arcury
- Department of Family and Community Medicine Wake Forest School of Medicine Winston‐Salem North Carolina USA
| | - Stephanie S. Daniel
- Department of Family and Community Medicine Wake Forest School of Medicine Winston‐Salem North Carolina USA
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Quandt SA, Arnold TJ, Mora DC, Arcury TA, Talton JW, Daniel SS. Hired Latinx Child Farmworkers in North Carolina: Educational Status and Experience Through a Social Justice Lens. New Solut 2021; 30:282-293. [PMID: 33131378 PMCID: PMC7856296 DOI: 10.1177/1048291120970207] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We examine the educational experience of Latinx hired child farmworkers in North Carolina, using a social justice framework. Qualitative (n = 30) and quantitative (n = 202) data collected among children ten to seventeen years of age revealed elevated rates of grade retention and dropout status. Children reported disruption to their schooling caused by international and interstate migration and intrastate movement. Few worked during school time; nevertheless, children reported missed participation in educational enrichment opportunities and little integration into school life. Schools often failed to accommodate language difficulties and problems caused by migration, and an atmosphere of racism prevailed. Educational programs for children in farmworker families were established during the 1960s. However, they do not meet the needs of hired child farmworkers. Policies to reduce child employment in agriculture and to meet their educational needs are necessary to ensure the education needed for future health and well-being. We discuss the applied implications of findings.
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Affiliation(s)
- Sara A Quandt
- Wake Forest School of Medicine, Winston-Salem, NC, USA
| | | | - Dana C Mora
- Wake Forest School of Medicine, Winston-Salem, NC, USA
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Respiratory Health and Suspected Asthma among Hired Latinx Child Farmworkers in Rural North Carolina. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217939. [PMID: 33138070 PMCID: PMC7662586 DOI: 10.3390/ijerph17217939] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 10/14/2020] [Accepted: 10/27/2020] [Indexed: 01/24/2023]
Abstract
The aim of this study was to evaluate respiratory health problems, including suspected asthma, and healthcare provider utilization among a sample of Latinx hired child farmworkers in rural North Carolina (n = 140). In 2018, a respiratory health questionnaire and breathing tests were collected from Latinx child (11–19 years) farmworkers (35.0% girls and 65.0% boys). Overall, 21.4% of children reported having been told by a medical provider that they had asthma, yet based on a combination of responses to respiratory survey questions, 36.4% or 15% more were identified as having suspected asthma. While 56.4% reported having a regular medical doctor, 38% had not had a medical exam in the past year. Respiratory dysfunction, including suspected, or uncontrolled asthma was prevalent among this group. Latinx children working in agriculture are vulnerable to occupational hazards and exposures and require assurances that they will receive access to high quality healthcare services that include routine respiratory health screenings.
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Arcury TA, Quandt SA, Arnold TJ, Chen H, Sandberg JC, Kearney GD, Daniel SS. Work Safety Culture of Latinx Child Farmworkers in North Carolina. Am J Ind Med 2020; 63:917-927. [PMID: 33311830 DOI: 10.1002/ajim.23161] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background Little research has addressed the safety environment of child farmworkers. This analysis examines the work safety culture experienced by Latinx child farmworkers in North Carolina. Methods Survey interviews were conducted in 2017 with 202 Latinx children aged 10 to 17 years employed on North Carolina farms. Analysis included measures of the behavioral, situational, and psychological elements of work safety culture. Results The work culture on North Carolina farms employing Latinx child farmworkers places limited value on safety. Behaviorally, many did not wear appropriate work clothing (e.g., 47.5% wore gloves, 37.1% wore boots). Situationally, few received safety training for tools (40.6%), machinery (24.3%), or pesticides (26.0%); about one-third (33.7%) had worked piece-rate; and many did not have field sanitation services available (e.g., 37.1% had water for washing, 19.8% had soap). Safety attitudes were mixed, and work safety climate was low, with 21.8% stating that their supervisor was only interested in doing the job fast and cheaply. Greater safety training, field sanitation services, and work safety climate were associated with working in western North Carolina, migrant workers, limited English fluency, and working in tomatoes. Wearing appropriate work clothing, not working piece-rate, fewer unsafe work attitudes were associated with working in eastern North Carolina, seasonal worker, speaking English, and working in tobacco. Conclusions This research makes it apparent that efforts are needed to improve safety culture wherever child farmworkers are employed. Current policy is not providing a safe environment for children working on farms in the United States.
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Affiliation(s)
- Thomas A. Arcury
- Department of Family and Community Medicine Wake Forest School of Medicine Winston‐Salem North Carolina
| | - Sara A. Quandt
- Department of Epidemiology and Prevention, Division of Public Health Sciences Wake Forest School of Medicine Winston‐Salem North Carolina
| | - Taylor J. Arnold
- Department of Family and Community Medicine Wake Forest School of Medicine Winston‐Salem North Carolina
| | - Haiying Chen
- Department of Biostatistical and Data Science, Division of Public Health Sciences Wake Forest School of Medicine Winston‐Salem North Carolina
| | - Joanne C. Sandberg
- Department of Family and Community Medicine Wake Forest School of Medicine Winston‐Salem North Carolina
| | - Gregory D. Kearney
- Department of Public Health, Brody School of Medicine East Carolina University Greenville North Carolina
| | - Stephanie S. Daniel
- Department of Family and Community Medicine Wake Forest School of Medicine Winston‐Salem North Carolina
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Arcury TA, Quandt SA, Arnold TJ, Chen H, Daniel SS. Occupational Injuries of Latinx Child Farmworkers in North Carolina: Associations With Work Safety Culture. J Occup Environ Med 2020; 62:853-858. [PMID: 32769794 DOI: 10.1097/jom.0000000000001982] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVE This paper examines the association of occupational injuries with work safety culture among Latinx child farmworkers. METHODS Interviews were conducted in 2017 with 202 Latinx farmworkers aged 10 to 17 years. RESULTS Occupational injuries were common among the child farmworkers: for example, 66.8% reported any work injury and 45.5% reported heat-related illness. Work safety culture was inadequate; for example, most did not receive safety training, one-third reported having worked piece-rate; only a few field sanitation services were available, and perceived work safety climate was low. Work safety culture had a mixed association with occupational injuries, with safety training and a better perceived work safety climate having a direct association with occupational injuries. CONCLUSIONS Policy is needed to reduce child farmworker injuries. Strategies to improve the predictive value of the work safety culture model are required.
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Affiliation(s)
- Thomas A Arcury
- Department of Family and Community Medicine (Dr Arcury, Mr Arnold, Dr Daniel); Division of Public Health Sciences, Department of Epidemiology and Prevention (Dr Quandt); Division of Public Health Sciences, Department of Biostatistics and Data Science (Dr Chen), Wake Forest School of Medicine, Winston-Salem, North Carolina
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