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Objectives: The goal of this project was to determine if a mobile application displaying pesticide label information in Spanish and English was a viable approach to addressing safety and health dis...

Background The burden of adverse health effects from heat exposure is substantial, and outdoor workers who perform heavy physical work are at high risk. Though heat prevention interventions have been developed, studies have not yet systematically evaluated the effectiveness of approaches that address risk factors at multiple levels. Objective We sought to test the effectiveness of a multi-level heat prevention approach (heat education and awareness tools [HEAT]), which includes participatory training for outdoor agricultural workers that addresses individual and community factors and a heat awareness mobile application for agricultural supervisors that supports decisions about workplace heat prevention, in the Northwest United States. Design We designed the HEAT study as a parallel, comparison, randomized group intervention study that recruited workers and supervisors from agricultural workplaces. In intervention arm crews, workers received HEAT training, and supervisors received the HEAT awareness application. In comparison arm crews, workers were offered non-HEAT training. Primary outcomes were worker physiological heat strain and heat-related illness (HRI) symptoms. In both worker groups, we assessed HRI symptoms approximately weekly, and heat strain physiological monitoring was conducted at worksites approximately monthly, from June through August. Discussion To our knowledge, this is the first study to evaluate the effectiveness of a multi-level heat prevention intervention on physiological heat strain and HRI symptoms for outdoor agricultural workers. Trial registration ClinicalTrials.gov Registration Number: NCT04234802

Examine associations between pesticide exposure and signs or symptoms of parkinsonism.Prior to the 2014 pesticide spray season, the authors examined 38 active pesticide handlers aged 35 to 65 (median: 43.5) who participated in the State of Washington's cholinesterase monitoring program in the Yakima Valley, where cholinesterase-inhibiting insecticides are applied in fruit orchards. A movement disorder specialist assessed the workers using the Unified Parkinson's Disease Rating Scale (UPDRS) motor subscore 3 (UPDRS3). Participants also self-reported work and medical histories, including the UPDRS activities of daily living subscore 2 (UPDRS2). The authors explored the relation between these scores and lifetime occupational pesticide exposure while accounting for age.All participants were Hispanic men born in Mexico who had worked in agriculture for 4 to 43 years (median: 21 years, including 11 years applying pesticides, mostly in the United States). Ten participants (26%) reported difficulty with one or more UPDRS2 activities of daily living (maximum = 2), and nine (24%) had a UPDRS30 (maximum = 10). The most common symptom and sign, respectively, were excess saliva (n = 6) and action tremor (n = 5). UPDRS2 and UPDRS3 scores were unrelated to the number of years applying pesticides, but UPDRS3, especially action tremor, was positively associated with living on or by a farm.Symptoms and signs of parkinsonism were absent to mild in this small sample of active workers who apply cholinesterase-inhibiting insecticides in Washington State, USA. Future studies should be larger and examine older, retired workers with greater cumulative exposure to agricultural pesticides at work and home, including other types of agricultural pesticides.

Purpose: The Etiquetas bilingues de pesticidas, or Bilingual Pesticide Safety project, aims to put pesticide label health, safety, and environmental protection information directly into the hands o...

Purpose: Developed in partnership with Washington State Dairy Federation, Washington State University, and University of Washington, the e-learning Dairy Safety Kit (DSK) platform provides curated ...

Development of the Practical Solutions for Pesticide Safety guide used participatory research strategies to identify and evaluate solutions that reduce pesticide exposures for workers and their families and to disseminate these solutions. Project principles were (1) workplace chemicals belong in the workplace, and (2) pesticide handlers and farm managers are experts, with direct knowledge of production practices. The project's participatory methods were grounded in self-determination theory. Practical solutions were identified and evaluated based on five criteria: practicality, adaptability, health and safety, novelty, and regulatory compliance. Research activities that had more personal contact provided better outcomes. The Expert Working Group, composed of farm managers and pesticide handlers, was key to the identification of solutions, as were farm site visits. Audience participation, hands-on testing, and orchard field trials were particularly effective in the evaluation of potential solutions. Small work groups in a Regional Advisory Committee provided the best direction and guidance for a "user-friendly" translational document that provided evidence-based practical solutions. The "farmer to farmer" format of the guide was endorsed by both the Expert Working Group and the Regional Advisory Committee. Managers and pesticide handlers wanted to share their solutions in order to "help others stay safe," and they appreciated attribution in the guide. The guide is now being used in educational programs across the region. The fundamental concept that farmers and farmworkers are innovators and experts in agricultural production was affirmed by this study. The success of this process demonstrates the value of participatory industrial hygiene in agriculture.

Outdoor workers performing heavy physical labour in hot conditions are at increased risk for developing occupational heat-related illness. Seasonal harvesting of certain tree fruits in Washington occurs during summer months. In addition to environmental heat exposure, harvesting involves internal heat generation from physical work. We sought to characterise heat stress and physiological effects of heat stress (heat strain) in workers performing harvest activities. During the summer of 2015, 46 pear and apple harvesters participated in a cross-sectional study in Yakima Valley, Washington for one work shift during warmer periods in August (n = 34) and cooler periods in September (n = 12). Heat stress and strain were characterised using American Conference of Governmental Hygienist (ACGIH) guidelines, which recommend thermal Action Limits and Threshold Limit Values based on several factors including: environmental temperatures, metabolic rate of task, clothing ensembles, core body temperature, and heart rate. Heat exposure was measured near individual workers using hand-held Wet Bulb Globe Temperature (WBGT) monitors, metabolic rate was estimated using field observations and hip-mounted accelerometers, and research staff observed workers’ clothing. Heart rate and core body temperature were monitored using heart rate monitors and ingestible core body temperature sensors. Of the 46 participants, 25 (54.4%) exceeded the ACGIH Action Limit (WBGT 25°C), and 16 (34.8%) exceeded the Threshold Limit Value (WBGT 28°C) for a moderate work task (300 Watts). All participants exceeding the Threshold Limit Value were working in August. Using accelerometer data (n = 39), 12 (30.8%) exceeded the Action Limit and 4 (10.3%) exceeded the Threshold Limit Value. Heat strain data are currently being analysed. Under current conditions, workers are exposed to hazardous thermal environments. Future climate conditions may further impact physically intensive outdoor occupations. Effective approaches for reducing heat exposure and/or promoting biological adaptation to heat are needed to prevent heat-related illness in vulnerable working populations.

Kit Galvin, MS CIH; Jennifer Krenz, MS MPH; Pablo Palmandez, MSPacific Northwest Agricultural Safety & Health Center, University of Washington, Seattle, Washington, USAThis project’s purposes are t...

Background Heat-related illness (HRI) is an important cause of non-fatal illness and death in farmworkers. We sought to identify potential barriers to HRI prevention and treatment in Latino farmworkers. Methods We conducted three semi-structured focus group discussions with 35 Latino farmworkers in the Central Washington, USA area using participatory rural appraisal techniques. Interviews were audio taped and transcribed in Spanish. Three researchers reviewed and coded transcripts and field notes, and investigator triangulation was used to identify relevant themes and quotes. Results Although the majority of participants in our study reported never receiving formal HRI training, most participants were aware that extreme heat can cause illness and were able to accurately describe HRI symptoms, risk factors, and certain prevention strategies. Four main observations regarding farmworkers’ HRI-relevant beliefs and attitudes were identified: 1) farmworkers subscribe to varying degrees to the belief that cooling treatments should be avoided after heat exposure, with some believing that such treatments should be avoided after heat exposure, and others encouraging the use of such treatments; 2) the desire to lose weight may be reflected in behaviors that promote increased sweating; 3) highly caffeinated energy drinks are preferred to increase work efficiency and maintain alertness; and 4) the location of drinking water at work (e.g. next to restrooms) and whether water is clean, but not necessarily chemically-treated, are important considerations in deciding whether to drink the water provided at worksites. Conclusions We identified potential barriers to HRI prevention and treatment related to hydration, certain HRI treatments, clothing use, and the desire to lose weight among Latino farmworkers. Strategies to address potential barriers to HRI prevention and treatment in this population may include engineering, administrative, and health education and health promotion strategies at individual, workplace, community, and societal levels. Although farmworkers in our study were able to describe HRI risk factors, reported practices were not necessarily consistent with reported knowledge. Further study of potential knowledge-behavior gaps may uncover opportunities for additional HRI prevention strategies. Farmworkers and employers should be included in the development and evaluation of interventions to prevent HRI.