1. A Case-Crossover Study of Heat Exposure and Injury Risk in Outdoor Agricultural Workers
- Author
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Darrin Adams, June T. Spector, Richard A. Fenske, Max Lieblich, Lianne Sheppard, David K. Bonauto, Miriam M. Calkins, and Tania Busch-Isaksen
- Subjects
Male ,Critical Care and Emergency Medicine ,Hot Temperature ,Health Care Providers ,Poison control ,lcsh:Medicine ,010501 environmental sciences ,01 natural sciences ,Occupational safety and health ,Geographical locations ,0302 clinical medicine ,Risk Factors ,Epidemiology ,Medicine and Health Sciences ,lcsh:Science ,Cherries ,Trauma Medicine ,2. Zero hunger ,Multidisciplinary ,Cross-Over Studies ,Farmers ,Agriculture ,Plants ,Middle Aged ,030210 environmental & occupational health ,Traumatic injury ,Female ,Traumatic Injury ,Research Article ,Washington ,Adult ,medicine.medical_specialty ,Adolescent ,Crops ,Heat Stress Disorders ,Fruits ,03 medical and health sciences ,Young Adult ,Environmental health ,Injury prevention ,medicine ,Humidex ,Humans ,Weather ,0105 earth and related environmental sciences ,Aged ,Apples ,business.industry ,lcsh:R ,Organisms ,Biology and Life Sciences ,Odds ratio ,Confidence interval ,United States ,Health Care ,Logistic Models ,13. Climate action ,Musculoskeletal Injury ,North America ,lcsh:Q ,People and places ,business ,Crop Science - Abstract
Background Recent research suggests that heat exposure may increase the risk of traumatic injuries. Published heat-related epidemiological studies have relied upon exposure data from individual weather stations. Objective To evaluate the association between heat exposure and traumatic injuries in outdoor agricultural workers exposed to ambient heat and internal heat generated by physical activity using modeled ambient exposure data. Methods A case-crossover study using time-stratified referent selection among 12,213 outdoor agricultural workers with new Washington State Fund workers’ compensation traumatic injury claims between 2000 and 2012 was conducted. Maximum daily Humidex exposures, derived from modeled meteorological data, were assigned to latitudes and longitudes of injury locations on injury and referent dates. Conditional logistic regression was used to estimate odds ratios of injury for a priori daily maximum Humidex categories. Results The mean of within-stratum (injury day and corresponding referent days) standard deviations of daily maximum Humidex was 4.8. The traumatic injury odds ratio was 1.14 (95% confidence interval 1.06, 1.22), 1.15 (95% confidence interval 1.06, 1.25), and 1.10 (95% confidence interval 1.01, 1.20) for daily maximum Humidex of 25–29, 30–33, and ≥34, respectively, compared to < 25, adjusted for self-reported duration of employment. Stronger associations were observed during cherry harvest duties in the June and July time period, compared to all duties over the entire study period. Conclusions Agricultural workers laboring in warm conditions are at risk for heat-related traumatic injuries. Combined heat-related illness and injury prevention efforts should be considered in high-risk populations exposed to warm ambient conditions in the setting of physical exertion.
- Published
- 2016