Public Health Impact of Heat-Related Illness Among Migrant Farmworkers

Fleischer, Nancy L.; Tiesman, Hope M.; Sumitani, Jeri; Mize, Terry; Amarnath, Kumar Kartik; Bayakly, A. Rana; Murphy, Matthew

doi:10.1016/j.amepre.2012.10.020

Cited by 106 publications

(117 citation statements)

References 15 publications

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“…California farm work is often labour-intensive and exposes workers to high ambient temperatures, varying levels of physical exertion and reliance on the worker to maintain sufficient hydration 5 6. Agricultural workers often report symptoms of heat-related illness,4 7 and in the USA they are estimated to be 20 times more likely to have a heat-related illness than workers in other industries 8. This suggests the need to better describe heat strain and volume depletion in this population, but these issues have rarely been studied among US farmworkers.…”

Section: Introductionmentioning

confidence: 99%

Heat strain, volume depletion and kidney function in California agricultural workers

et al. 2017

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Background Agricultural work can expose workers to increased risk of heat strain and volume depletion due to repeated exposures to high ambient temperatures, arduous physical exertion and limited rehydration. These risk factors may result in acute kidney injury (AKI). Methods We estimated AKI cumulative incidence in a convenience sample of 283 agricultural workers based on elevations of serum creatinine between preshift and postshift blood samples. Heat strain was assessed based on changes in core body temperature and heart rate. Volume depletion was assessed using changes in body mass over the work shift. Logistic regression models were used to estimate the associations of AKI with traditional risk factors (age, diabetes, hypertension and history of kidney disease) as well as with occupational risk factors (years in farm work, method of payment and farm task). Results 35 participants were characterised with incident AKI over the course of a work shift (12.3%). Workers who experienced heat strain had increased adjusted odds of AKI (1.34, 95% CI 1.04 to 1.74). Piece rate work was associated with 4.24 odds of AKI (95% CI 1.56 to 11.52). Females paid by the piece had 102.81 adjusted odds of AKI (95% CI 7.32 to 1443.20). Discussion Heat strain and piece rate work are associated with incident AKI after a single shift of agricultural work, though gender differences exist. Modifications to payment structures may help prevent AKI.

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Section: Introductionmentioning

confidence: 99%

Heat strain, volume depletion and kidney function in California agricultural workers

et al. 2017

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“…Those who are paid by the piece may be more reluctant to take recommended breaks to rest in the shade or drink water because stopping work cuts into time that could be spent picking and may result in lower wages. 28 Therefore, those paid by the piece may inadvertently expose themselves to greater levels of occupational hazards, including heat illness and dehydration, 29 which may prove damaging to the kidneys. Fortunately, the method of paying agricultural workers is a modifiable risk factor and could be an approach to reducing incident AKI over a work-shift.…”

Section: Discussionmentioning

confidence: 99%

Cumulative Incidence of Acute Kidney Injury in California's Agricultural Workers

Moyce

Joseph

Tancredi

et al. 2016

Journal of Occupational &Amp; Environmental Medicine

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“…An earlier study on heat-related mortality in North Carolina found that almost half of all occupational heat-related deaths from 1977 to 2001 were among farm workers [35]. Several risk factors have been identified among this demographic, including the exertional nature of their work (many laborintensive crops are typically harvested in July), excessive clothing, poor housing conditions, lack of preventative training, lack of access to health care, and underlying illness or disease [19,34,[36][37][38]. Since we did not have access to any individual information on the circumstances surrounding each ED visit, we could not confirm what specific occupations were in fact associated with HRI.…”

Section: Discussionmentioning

confidence: 96%

Impact of Extreme Heat Events on Emergency Department Visits in North Carolina (2007–2011)

et al. 2015

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Extreme heat is the leading cause of weather-related mortality in the U.S. Extreme heat also affects human health through heat stress and can exacerbate underlying medical conditions that lead to increased morbidity and mortality. In this study, data on emergency department (ED) visits for heat-related illness (HRI) and other selected diseases were analyzed during three heat events across North Carolina from 2007 to 2011. These heat events were identified based on the issuance and verification of heat products from local National Weather Service forecast offices (i.e. Heat Advisory, Heat Watch, and Excessive Heat Warning). The observed number of ED visits during these events were compared to the expected number of ED visits during several control periods to determine excess morbidity resulting from extreme heat. All recorded diagnoses were analyzed for each ED visit, thereby providing insight into the specific pathophysiological mechanisms and underlying health conditions associated with exposure to extreme heat. The most common form of HRI was heat exhaustion, while the percentage of visits with heat stroke was relatively low (<10%). The elderly (>65 years of age) were at greatest risk for HRI during the early summer heat event (8.9 visits per 100,000), while young and middle age adults (18-44 years of age) were at greatest risk during the mid-summer event (6.3 visits per 100,000). Many of these visits were likely due to work-related exposure. The most vulnerable demographic during the late summer heat event was adolescents (15-17 years of age), which may relate to the timing of organized sports. This demographic also exhibited the highest visit rate for HRI among all three heat events (10.5 visits per 100,000). Significant increases (p < 0.05) in visits with cardiovascular and cerebrovascular diseases were noted during the three heat events (3-8%). The greatest increases were found in visits with hypotension during the late summer event (23%) and sequelae during the early summer event (30%), while decreases were noted for visits with hemorrhagic stroke during the middle and late summer events (13-24%) and for visits with aneurysm during the early summer event (15%). Significant increases were also noted in visits with respiratory diseases (5-7%). The greatest increases in this category were found in visits with pneumonia and influenza (16%), bronchitis and emphysema (12%), and COPD (14%) during the early summer event. Significant increases in visits with nervous system disorders were also found during the early summer event (16%), while increases in visits with diabetes were noted during the mid-summer event (10%).

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Public Health Impact of Heat-Related Illness Among Migrant Farmworkers

Cited by 106 publications

References 15 publications

Heat strain, volume depletion and kidney function in California agricultural workers

Heat strain, volume depletion and kidney function in California agricultural workers

Cumulative Incidence of Acute Kidney Injury in California's Agricultural Workers

Impact of Extreme Heat Events on Emergency Department Visits in North Carolina (2007–2011)

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