Surveillance data show that pesticide-related illness is an important cause of acute morbidity among migrant farm workers in California. Exposures occur in various ways (e.g., residues, drift), suggesting that the use of pesticides creates a hazardous work environment for all farm workers Improved education for health care providers should be a priority. Growers should be educated about alternative forms of pest control and incentives should be provided to encourage their use.
Describes the growth from 1987 through 1996 of the Occupational Pesticide Poisoning Surveillance Program at the Texas Department of Health. The program was initially based on a Sentinel Event Notification System for Occupational Risks (SENSOR) model, using sentinel providers to report cases, supplementing the passive reporting by physicians that was required by law.
The authors describe the growth of the Occupational Pesticide Poisoning Surveillance Program at the Texas Department of Health. The program was based on a Sentinel Event Notification System for Occupational Risks(SENSOR) model, using sentinel providers to report cases. The number of confirmed occupational cases increased from 9 workers in 1987 to 99 workers in 1996.
Matthew C. Keifer, MD, MPH; Iris Reyes, MPH; Amy K. Liebman, MA, MPA; Patricia Juarez-Carrillo, PhD, MPH. Abstract. Audience response systems (ARS) have long been used to improve the interactivity of educational activities. Most studies of ARS have addressed education of literate trainees. How well these devices work with low-literacy subjects is not well studied. Information gathering on the training audience is an important use of ARS and helpful in improving the targeting of training information. However, obtaining demographic information from vulnerable populations with reasons to be concerned about divulging information about themselves has not been tested. In addition, a culturally competent method to effectively collect demographic and evaluation data of this growing population is essential. This project investigated the use of ARS to gather information from Hispanic immigrant workers, many of whom are socially vulnerable and have limited English proficiency (LEP) and low-literacy. Workers attended focus groups and were asked to use ARS devices or clickers to respond to questions. Questions were both catergorical (multiple choice) and open-ended numerical (text entry), and varied from simple queries to more sensitive points regarding immigration. Most workers answered the one-key response categorical questions with little difficulty. In contrast, some participants struggled when responding to numerical questions, especially when the response required pressing multiple clicker keys. An overwhelming majority of participants reported that the clickers were comfortable and easy to use despite the challenges presented by the more complex responses. The error rate increased as question complexity increased and the trend across three ordered categories of response complexity reached statistical significance. Results suggest that ARS is a viable method for gathering dichotomous or higher-order categorical information from LEP and low-literacy populations in a group setting while assuring anonymity. However, it is recommended that clickers be developed and tested with fewer, bigger, and more widely separated buttons, and less printing on the buttons for these populations. Further research is needed to determine the effectiveness of using clickers with simplified configurations in the workplace as a tool to collect data for surveys and assessments and to better engage LEP and low-literacy workers in training sessions.
- Keifer_etal_ARS_JAM_2014.pdf (334.48 KB)
Hombres Unidos is a peer-led workshop focused on the primary prevention of sexual and intimate partner violence (s/ipv) with Latino migrant men. Developed in 2005 with the support from the Centers for Disease and Control, this five session workshop is implemented using a popular education technique (Paulo Freire) which is a concept that incorporates notions of class, political struggle and social transformation.
This webinar (sponsored by the Washington Coalition of Sexual Assault Programs) focuses on the collaborative development of a primary prevention workshop for Latino migrant men, the evaluation of the workshop, and the continuing effort on engaging Latino migrant men as allies with women in s/ipv prevention after the five session workshop.
After this webinar, participants will be able to identify:
- methods on how to begin a conversation on sexual and intimate partner violence with Latino migrant men
- process and outcome evaluation techniques on a primary prevention workshop developed for a specific population
- efforts to continue to engage Latino migrant men in sexual and intimate partner violence prevention
- how to incorporate existing efforts with your population
Recording & Materials
During the webinar, Adrian referenced a few handouts that are used in the program. Below you will find a few of these in Spanish.
- http://www.wcsap.org/engaging-latino-migrant-men-violence-prevention-webinar
- http://www.wcsap.org/sites/wcsap.huang.radicaldesigns.org/files/uploads/webinars/Hombres_Unidos/index.htm
- http://www.wcsap.org/sites/wcsap.huang.radicaldesigns.org/files/uploads/trainings_events/recorded_webinars/EngagingLatinoMigrantMenViolencePrevention_10.29.13.pdf
- http://www.wcsap.org/sites/wcsap.huang.radicaldesigns.org/files/uploads/webinars/ContinuumSpanish_EmotionalPsychological.pdf
- http://www.wcsap.org/sites/wcsap.huang.radicaldesigns.org/files/uploads/webinars/WheelSpanish_Equality.pdf
- http://www.wcsap.org/sites/wcsap.huang.radicaldesigns.org/files/uploads/webinars/WheelSpanish_PowerandControl.pdf
Summary of Results from the California Pesticide Illness Surveillance Program - 2010.
The Department of Pesticide Regulation administers the California pesticide safety program, widely regarded as the most stringent in the nation. Mandatory reporting of pesticide illnesses has been part of this comprehensive program since 1971. Illness reports are collected, evaluated and analyzed by program staff. PISP is the oldest and largest program of its kind in the nation; its scientists provide data to regulators, advocates, industry, and indivudal citizens.
- CEPA2010_Report.pdf (467.41 KB)
The CHAMACOS study is a longitudinal birth cohort study examining chemicals and other factors in the environment and children's health.
In 1999-2000, CHAMACOS enrolled 601 pregnant women living in the agircultural Salinas Valley. They are following their children through age 12 to measure their exposures to pesticides and other chemicals and to determine if this exposure impacts their growth, health, and development.
Despite ongoing concern about pesticide exposure of farmworkers and their families, relatively few studies have tried to directly test the association of behavioral and environmental factors with pesticide exposure in this population. This study seeks to identify factors potentially associated with pesticide exposure among farmworkers; grade the evidence in the peer-reviewed literature for such associations; and propose a minimum set of measures necessary to understand farmworker risk for pesticide exposure. From: Environmental Health Perspectives
- Quandt Hernanez-Valero et al.pdf (457.88 KB)
Print, cut, and distribute this handy bookmark to providers who treat migrant and seasonal farmworker patients. The bookmark includes links and a qr code to connect you to pesticide - related clinical tools and resources. In addition, we've included some useful phone numbers in case of a pesticide emergency.
You can also use the bookmark to keep handy the Health Network phone number to be sure your patients on the move remain in care.
- EOHbookmark_final_92013.pdf (722.68 KB)
Reducing exposure to toxic environmental agents is a critical area of intervention for obstetricians, gynecologists, and other reproductive health care professionals. The evidence that links exposure to toxic environmental agents and adverse reproductive and developmental health outcomes is sufficiently robust, and the American College of Ostetricicans and Gynecologists and the American Society for Reproductive Medicine join leading scientists and other clinical practitioners in calling for timely action to identify and reduce exposure to toxic envrionmental agents while addressing the consequences of such exposure.
- ACOG UCSF2013.pdf (378.64 KB)
Families Talking Together (FTT) is an evidence based program designed to help Latino parents better communicate with their children and teens about healthy relationships, sex, contraceptive use, and preventing pregnancy. Dr. Vincent Guilamo-Ramos, the creator of the program and co-director of the Center for Latino Adolescent and Family Health at New York University’s Silver School of Social work, along with Planned Parenthood Los Angeles and Visión y Compromiso, recently enlisted 25 promotores (community health workers) from three communities in California with high rates of teen pregnancy and high percentages of Latinos in an effort to help Latino parents address teen pregnancy. Over a four-day period, the 25 promotores were trained to deliver the FTT intervention. In the next two months, the promotores will deliver the intervention to 250 families in California. The National Campaign wishes to recognize and thank Dr. Guilamo-Ramos, PPLA, and Visión y Compromiso for their work on this innovative and important project.
The FTT intervention—both the community health worker curriculum and parent materials---are available online, free of charge.
- FTT CHW Curriculum.pdf (2.41 MB)
- http://store.thenationalcampaign.org/site/R?i=iOPIGHCt4_sel75YCj4CNg
- http://store.thenationalcampaign.org/site/R?i=zbpZq567mdRyAhRMqfLBfw
- http://store.thenationalcampaign.org/site/R?i=oFELeuVlpFN4_3HuvAZKVg
- http://store.thenationalcampaign.org/site/R?i=8sPNa0ckhtnq8c2n-KUhDQ
- http://store.thenationalcampaign.org/site/R?i=uejouwu2KrBvV0GyidmHLA
- http://store.thenationalcampaign.org/site/R?i=63niYLc_nPHYmxs-ZRZJHQ
A report prepared by researchers at The George Washington University School of Public Health and Health Services features a wealth of information on occupational health and safety and the migrant population, from farmworkers to fast-food chain employees to restaurant cooks and servers.
News release:
http://defendingscience.org/news/labor-day-looking-back-year-us-occupational-health-and-safety
- H&S Report2013 reduced size.pdf (3.21 MB)
Two high-production value, Spanish radio public service announcements(PSAs) to promote HIV testing services at local agencies. One PSA targets men and the other women. Each PSA features a blank space for you to record your organization’s contact information. Provided by Farmworker Justice
Comprehensive Spanish-language curriculum for individuals interested in training promotores de salud in HIV prevention. The curriculum is based on popular education techniques, and is culturally competent and linguistically sensitive.
Provided by Farmworker Justice
A directory of organizations working to promote health and prevent HIV/AIDS in California, Florida, North Carolina, Oregon, and Texas.
Provided by Farmworker Justice
This webinar is the sixth in a series of seven in our Clinician Orienatation to Migration Health.
DATE RECORDED: Wednesday, July 17, 2013
PRESENTED BY: Candace Kugel, FNP, CNM, Specialist in Clinical Systems & Women's Health and Melissa Bailey, Executive Director of North Carolina Field, Inc.
To view the recorded version of this webinar, click here.
- OrientationWomen2013_0.pdf (3.57 MB)
Geoffrey M. Calvert, Walter A. Alarcon, Ann Chelminski,Mark S. Crowley, Rosanna Barrett, Adolfo Correa, SheilaHiggins, Hugo L. Leon, Jane Correia, Alan Becker,Ruth H. Allen and Elizabeth Evans
doi:10.1289/ehp.9647 (available at http://dx.doi.org/) Online 21 February 2007
- BirthDefectsCaseReportEHPArticle_0.pdf (333.39 KB)
Introduction
In August of 2005, the North Carolina Division of Public Health, Occupational and Environmental Epidemiology Branch (OEEB) was notified that three women who had worked on farms in North Carolina owned by Ag-Mart had delivered infants with birth defects. All three births took place in Florida where the women also worked on Ag-Mart farms and lived near each other. This report summarizes the OEEB’s investigation and assessment of the pesticide exposures likely experienced by these women while in North Carolina.
- Agmartreleasereport.doc (198.5 KB)
The Occupational Health and Safety Resource Center is a virtual repository of Spanish educational materials, data sources, and links to bilingual informational websites on occupational health and safety issues related to agricultural work. It also contains an ample list of national and state agencies that have produced materials in Spanish for farmworkers’ health-related problems.
MCNs own Deliana Garcia helped in being a part of the advisory committee to this resource center.
What is the objective? To facilitate a central access point to high quality Spanish educational materials on agricultural occupational health and safety issues for people conducting work on health promotion and prevention activities and on workers’ rights and problems related to agricultural work.
Who are the target audiences? Health-outreach workers (promotores), community advocates, health providers, contractors/employers, farmworkers and their families, and others interested in the health and safety issues of agricultural workers.
What areas are included? The materials cover five key relevant areas: 1) Farmworkers’ rights; 2) Injury prevention; 3) Respiratory illnesses; 4) Heat illnesses; and 5) Pesticide exposure.
How did we do it? To develop the Virtual Resource Center, the process entailed:
- Asset mapping of educational, informational and research materials available in Spanish related to the five mentioned areas.
- Selection of materials using the following criteria: accurate information, culturally and linguistically adequate (including literacy level), relevant to health area, and visually acceptable quality.
- Insertion of resources into an excel format under five different categories, including source, type of material, and description of its content.
Development of new materials: to complement the existing educational resources, we developed a “Promotores Training Manual on Occupational Health and Safety of Agricultural Workers”. Based on an ethnographic framework, the manual presents the perspective of agricultural workers on the five mentioned areas (their stories) and provides community health workers with tools on how to conduct prevention and promotion activities. It also refers them to existing resources. We also produced a series of Spanish and selected indigenous languages Public Service Announcements (PSAs) on these areas.
An informative blog about workers' compensation, risk management, business insurance, workplace health & safety, occupational medicine, injured workers, and related topics.
This webinar is the fifth in a series of seven in our Clinician Orienatation to Migration Health.
DATE RECORDED: Wednesday, June 12th, 2013
PRESENTED BY: Dr. Jennie McLaurin, MD, MPH, Specialist in Child and Migrant Health, Migrant Clinicians Network
To view the recorded version of this webinar, click here.
Much of the medical home model is predicated on a relatively stable population that can access regular care at a single network of providers. So how can this model effectively transfer to a mobile population? One of the key elements needed is a more expansive vision of a medical home beyond a single geographic location. This session will explore strategies to create a patient centered medical home for patients on the move. The session will include an update and overview of MCN’s Health Network to manage critical health care issues such as infectious disease, Cancer, Diabetes and Pre-natal patient navigations. Participants will also be engaged in a discussion around best practices in tracking outcomes and reporting test results to patients. Presenters will highlight innovative promising practices in the creation of patient centered medical homes for migrant patients.
The Diabetes and Healthy Eyes Toolkit provides community health workers with tools to inform people with diabetes about diabetic eye disease and maintaining healthy vision. The toolkit has a flipchart that is easy to use in community settings and can be incorporated into existing diabetes classes or information sessions. It is available in English andSpanish.
California Poison Control System developed an online game that focuses on poison prevention through the use of "look-a-like" pills and candy. There are other resources on the site. The game is available as an app on itunes and in the android marketplace. Search for 'Choose your Poison.'
This website and training material were developed to give communities and promotores ways to help farm workers learn how to protect themselves from pesticide exposure.
The project and all materials on the website were developed by the California Poison Control System in collaboration with the the Western Center for Agricultural Health and Safety at the University of California, Davis and the California Department of Pesticide Regulation.
- DPR_Facilitator_Manual_EN.pdf (4.77 MB)
- DPR_Participant_Manual_EN.pdf (4.91 MB)
Part 4 of 7 webinars in the CLINICIAN ORIENTATION TO MIGRATION HEALTH series.
DATE RECORDED: May 15, 2013
PRESENTERS: Amy K. Leibman, MPA, MA, Director of Environmental and Occupational Health, Migrant Clinicians Network
Dr. Mike Rowland, MD, MPH, Vice President, Medical Affairs and Medical Director, Occupational Health, Franklin Memorial Hospital
OBJECTIVES:
- Recognize the unique health risks of migrants due to their working conditions and environment
- Identify promising practices in environmental and occupational health that are feasible to implement in Migrant and Community Health Centers
- Utilize online clinical and patient education tools and resources to recognize, prevent and manage environmental and occupaional illnesses and injuries
- EOHPrimaryCareProviders_webinar.pdf (4.37 MB)
Sherry L. Baron, MD, MPH, Sharon Beard, MS, Letitia K. Davis, ScD, EdM, Linda Delp, PhD, MPH, Linda Forst, MD, MPH, Andrea Kidd-Taylor, PHD, Amy K. Liebman, MPA, MA, Laura Linnan, ScD, Laura Punnett, ScD, and Laura S. Welch, MD
Background: Nearly one of every three workers in the United States is low-income. Low-income populations have a lower life expectancy and greater rates of chronic diseases compared to those with higher incomes. Low- income workers face hazards in their workplaces as well as in their communities. Developing integrated public health programs that address these combined health hazards, especially the interaction of occupational and non-occupational risk factors, can promote greater health equity.
Methods: We apply a social-ecological perspective in considering ways to improve the health of the low-income working population through integrated health protection and health promotion programs initiated in four different settings: the worksite, state and local health departments, community health centers, and community-based organizations.
Results: Examples of successful approaches to developing integrated programs are presented in each of these settings. These examples illustrate several complementary venues for public health programs that consider the complex interplay between work related and non work-related factors, that integrate health protection with health promotion and that are delivered at multiple levels to improve health for low-income workers.
Conclusions: Whether at the workplace or in the community, employers, workers, labor and community advocates, in partnership with public health practitioners, can deliver comprehensive and integrated health protection and health promotion programs. Recommendations for improved research, training, and coordination among health departments, health practitioners, worksites and community organizations are proposed.
- final PDF.pdf (195.08 KB)
Carlos Eduardo Siqueira, MD, ScD, Megan Gaydos, MPH, Celeste Monforton, Dr PH, MPH, Craig Slatin, ScD, MPH, Liz Borkowski, BA, Peter Dooley, MS, CIH, CSP, Amy Liebman, MPA, MA, Erica Rosenberg, JD, Glenn Shor, PhD, MPP, and Matthew Keifer, MD, MPH
Background This article introduces some key labor, economic, and social policies that historically and currently impact occupational health disparities in the United States.
Methods We conducted a broad review of the peer-reviewed and gray literature on the effects of social, economic, and labor policies on occupational health disparities.
Results Many populations such as tipped workers, public employees, immigrant workers, and misclassified workers are not protected by current laws and policies, including worker’s compensation or Occupational Safety and Health Administration enforcement of standards. Local and state initiatives, such as living wage laws and community benefit agreements, as well as multiagency law enforcement contribute to reducing occupational health disparities.
Conclusions There is a need to build coalitions and collaborations to command the resources necessary to identify, and then reduce and eliminate occupational disparities by establishing healthy, safe, and just work for all.
Sara A. Quandt, PhD, Kristen L. Kucera, PhD, Courtney Haynes, MS, Bradley G. Klein, PhD, Ricky Langley, MD, Michael Agnew, PhD, Jeffrey L. Levin, MD, Timothy Howard, PhD, and Maury A. Nussbaum, PhD
Background Workers in the Agriculture, Forestry, and Fisheries (AgFF) sector experience exposures directly related to the work itself, as well as the physical environment in which the work occurs. Health outcomes vary from immediate to delayed, and from acute to chronic.
Methods We reviewed existing literature on the health outcomes of work in the AgFF sector and identified areas where further research is needed to understand the impact of these exposures on immigrant Latino workers in the southeastern US.
Results Outcomes related to specific body systems (e.g., musculoskeletal, respiratory) as well as particular exposure sources (e.g., pesticides, noise) were reviewed. The most extensive evidence exists for agriculture, with a particular focus on chemical exposures. Little research in the southeastern US has examined health outcomes of exposures of immigrant workers in forestry or fisheries.
Conclusion As the AgFF labor force includes a growing number of Latino immigrants, more research is needed to characterize a broad range of exposures and health outcomes experienced by this population, particularly in forestry and fisheries.
- 3 Quandt et al Occupational health outcomes.pdf (183.18 KB)
Arthur L. Frank, MD, PhD, Amy K. Liebman, MPH, MA, Bobbi Ryder, BA, Maria Weir, MAA, MPH, and Thomas A. Arcury, PhD
Background The Agriculture, Forestry, and Fishery (AgFF) Sector workforce in theUS is comprised primarily of Latino immigrants. Health care access for these workersis limited and increases health disparities.
Methods This article addresses health care access for immigrant workers in the AgFF Sector, and the workforce providing care to these workers.
Contents Immigrant workers bear a disproportionate burden of poverty and ill health and additionally face significant occupational hazards. AgFF laborers largely are uninsured, ineligible for benefits, and unable to afford health services. The new Affordable Care Act will likely not benefit such individuals. Community and Migrant Health Centers (C/MHCs) are the frontline of health care access for immigrant AgFF workers.C/MHCs offer discounted health services that are tailored to meet the special needs of their underserved clientele. C/MHCs struggle, however, with a shortage of primary care providers and staff prepared to treat occupational illness and injury among AgFF workers. A number of programs across the US aim to increase the number of primary care physicians and care givers trained in occupational health at C/MHCs. While such programs are beneficial, substantial action is needed at the national level to strengthen and expand the C/MHC system and to establish widely Medical Home models and Accountable Care Organizations. System-wide policy changes alone have the potential to reduce and eliminate the rampant health disparities experienced by the immigrant workers who sustain the vital Agricultural, Forestry, and Fishery sector in the US. Am. J. Ind. Med.
By Amy K. Liebman, MPA, MA, Melinda F. Wiggins, MTS, Clermont Fraser, JD, Jeffrey Levin, MD, MSPH, Jill Sidebottom, PhD, and Thomas A. Arcury, PhD
Background Immigrant workers make up an important portion of the hired workforce inthe Agricultural, Forestry and Fishing (AgFF) sector, one of the most hazardous industrysectors in the US. Despite the inherent dangers associated with this sector, workerprotection is limited.
Methods This article describes the current occupational health and safety policies andregulatory standards in theAgFF sector and underscores the regulatory exceptions and limitationsin worker protections. Immigration policies and their effects on worker health and safety arealso discussed. Emphasis is placed on policies and practices in the Southeastern US.
Results Worker protection in the AgFF sector is limited. Regulatory protections are generallyweaker than other industrial sectors and enforcement of existing regulations is woefullyinadequate. The vulnerability of the AgFF workforce is magnified by worker immigrationstatus. Agricultural workers in particular are affected by a long history of “exceptionalism”under the law as many regulatory protections specifically exclude this workforce.
Conclusions A vulnerable workforce and high-hazard industries require regulatoryprotections that, at a minimum, are provided to workers in other industries. A systematicpolicy approach to strengthen occupational safety and health in the AgFF sector mustaddress both immigration policy and worker protection regulations.
- 5 Liebman et al Occupational health policy.pdf (123.07 KB)