Abstract:Respiratory protection in agriculture has lagged behind other industries. Migrant farmworkers often work in dusty environments yet do not receive appropriate, fitted respiratory protection. During May and June of 2013, researchers pilot-tested a respiratory protection program adapted to fit the unique needs of migrant and seasonal farmworkers. It was implemented in Spanish, with literacy support, at convenient times and locations. Additionally, staff was known to workers, and a farmworker medical center provid… Show more
“… 63 67 74 Masks that are a good fit for Caucasian Americans have been shown to provide adequate fit for only 41% of Latino workers. 62 Additionally, two European studies demonstrate low PR among HWCs, suggesting current RPE may be inadequate, however, the ethnic distribution of these populations was not reported. 30 73 …”
Section: Resultsmentioning
confidence: 97%
“…Four studies included a Caucasian population, 48 55 60 69 five studied a Korean population, 29 52 53 65 68 two studied a Chinese population, 63 72 three studied an Iranian population, 67 71 74 one studied a Taiwanese population 66 and one studied a Latino migrant workers population. 62 Eight studies had populations of mixed ethnicity, 27 28 50 51 57 59 61 75 with the predominant group being Caucasian or black/African. Ethnicity was not reported for eight studies, which were based in Australia, France, Spain, UK and the USA.…”
IntroductionBlack, Asian and minority ethnic (BAME) people are disproportionately affected by COVID-19. Respiratory protective equipment (RPE) has conventionally been developed for a predominantly white male population that does not represent the healthcare workforce. The literature was reviewed to determine the protection offered to female and BAME users.MethodsFive databases were searched. Eligible studies related to respirator fit in the context of anthropometrics, gender and ethnicity. Meta-analysis was performed for gender-based anthropometric differences. A priori protocol registration was not performed.Results32 studies were included and anthropometric data was extracted from 15 studies. Meta-analysis revealed 14 anthropometric measurements were significantly smaller for females. Mean differences ranged from 0.37 mm to 22.05 mm. Gender-based anthropometric differences did not always translate to lower fit factor scores, with 12 studies reporting worse performance and fit for females and 10 reporting no gender effect. No studies provided disaggregate anthropometric data by ethnic group. Pass rates (PR) were low or moderate in 12 BAME or mixed-ethnicity cohorts. 14 studies reported associations between facial dimensions (FD) and respirator fit. Three comparative studies showed lower PR among selective BAME people. 18 studies reported RPE performance differed with model and design. Most studies did not prespecify inclusion/exclusion criteria. Small sample size and lack of justification or power calculations was a concern. Significant heterogeneity in study designs limited comparisons, particularly relating to respirator selection or availability and defining study outcomes relating to RPE performance.ConclusionThe literature reports on largely Caucasian or single ethnic populations, and BAME people remain under-represented, limiting comparisons between ethnic groups. Facial anthropometrics vary between gender and likely between ethnicity, which may contribute to lower PR among females and ethnic minorities, particularly Asians. There is a need for studies including a broader spectrum of ethnicities and for consideration of female and BAME users during RPE development.
“… 63 67 74 Masks that are a good fit for Caucasian Americans have been shown to provide adequate fit for only 41% of Latino workers. 62 Additionally, two European studies demonstrate low PR among HWCs, suggesting current RPE may be inadequate, however, the ethnic distribution of these populations was not reported. 30 73 …”
Section: Resultsmentioning
confidence: 97%
“…Four studies included a Caucasian population, 48 55 60 69 five studied a Korean population, 29 52 53 65 68 two studied a Chinese population, 63 72 three studied an Iranian population, 67 71 74 one studied a Taiwanese population 66 and one studied a Latino migrant workers population. 62 Eight studies had populations of mixed ethnicity, 27 28 50 51 57 59 61 75 with the predominant group being Caucasian or black/African. Ethnicity was not reported for eight studies, which were based in Australia, France, Spain, UK and the USA.…”
IntroductionBlack, Asian and minority ethnic (BAME) people are disproportionately affected by COVID-19. Respiratory protective equipment (RPE) has conventionally been developed for a predominantly white male population that does not represent the healthcare workforce. The literature was reviewed to determine the protection offered to female and BAME users.MethodsFive databases were searched. Eligible studies related to respirator fit in the context of anthropometrics, gender and ethnicity. Meta-analysis was performed for gender-based anthropometric differences. A priori protocol registration was not performed.Results32 studies were included and anthropometric data was extracted from 15 studies. Meta-analysis revealed 14 anthropometric measurements were significantly smaller for females. Mean differences ranged from 0.37 mm to 22.05 mm. Gender-based anthropometric differences did not always translate to lower fit factor scores, with 12 studies reporting worse performance and fit for females and 10 reporting no gender effect. No studies provided disaggregate anthropometric data by ethnic group. Pass rates (PR) were low or moderate in 12 BAME or mixed-ethnicity cohorts. 14 studies reported associations between facial dimensions (FD) and respirator fit. Three comparative studies showed lower PR among selective BAME people. 18 studies reported RPE performance differed with model and design. Most studies did not prespecify inclusion/exclusion criteria. Small sample size and lack of justification or power calculations was a concern. Significant heterogeneity in study designs limited comparisons, particularly relating to respirator selection or availability and defining study outcomes relating to RPE performance.ConclusionThe literature reports on largely Caucasian or single ethnic populations, and BAME people remain under-represented, limiting comparisons between ethnic groups. Facial anthropometrics vary between gender and likely between ethnicity, which may contribute to lower PR among females and ethnic minorities, particularly Asians. There is a need for studies including a broader spectrum of ethnicities and for consideration of female and BAME users during RPE development.
“…Thirty‐two articles (30%) mentioned culture in relation to health and safety training, education, outreach or intervention. Most of these articles noted the challenges stemming from cultural differences and the need for or examples of culturally appropriate programs, with language and culture often mentioned together in this regard. In some cases, researchers advocated modifying workers’ attitudes and behaviors such as enhancing workers’ cultural skills, establishing and communicating proper conduct for employees, putting in place “An intervention for assertive communication skills such as disagreeing or refusing requests,” (p211) and deconstructing the “hardworking Latino” stereotype for day labourers and employers .…”
Section: Resultsmentioning
confidence: 99%
“…Twenty‐five articles (23%) discussed the cultural competence of providers and health care systems, including the need for culturally sensitive care that considers the cultural beliefs, behaviors, roles, and practices of immigrant or migrant workers . For example, Bailey et al wrote, in their study on migrants working at the back stretch of a Philadelphia racetrack:“Health professionals may understand that while many Mexican workers are initially agreeable, agreement does not mean that there will be adherence to a prescribed plan of care.…”
Background
Health and safety researchers and practitioners have proposed that cultural differences help explain inequalities between foreign and native‐born workers. While cultural explanations for inequalities have long been debated in other fields, there exists little critique of cultural discourses in occupational health.
Methods
This article examines and discusses the discourse on culture in 107 articles on immigrant or migrant workers’ health published between 2011 and 2015. For each article, passages on culture were identified and analysed for both the context and the manner in which culture was discussed.
Results
The discourse on culture was found to be generally simplistic, individualistic, and uncritical, intentionally or unintentionally supporting the worldview that workers’ “otherness” is both cause of inequalities and target for interventions.
Conclusion
The article argues that empirical, theoretical and interdisciplinary work is needed to document the mechanisms and pathways that underlie health and safety inequalities by foreign‐born status.
“…In this study, the OSFA respirators, including the DUO and Climax brands had lower proportions of passing IAA fit tests compared to the AoSafety brands with a three-size system (2.40% and 4.90% vs. 29.30%). One explanation for this finding was that each brand of studied respirators resulted in significantly different results 38 – 41 ) . Meanwhile, the respirator brands with system-size classifications (two-, three-, five-sizes) and various styles provide more options to select the well-fitting respirators by the wearers, as specified by the respiratory protection standards 1 – 3 ) .…”
To examine the fit testing of elastomeric half face-piece respirators (EHRs), a total of 41 candidates were randomly assigned into seven EHRs equipped with organic vapor (OV) cartridges which were commonly used in the Iranian industrial workplaces. The qualitative fitting into the facial dimensions was assessed using the Allegro Isoamyl Acetate fit test kit. While the studied EHRs showed very low passing fit testing rates, the 3M, AoSafety (Medium), and AoSafety (Large) had the highest passing rates with 22.0%, 14.60%, and 9.76%, respectively. The AoSafety (All sizes) delivered a higher passing fit test rate than the 3M brand (29.30 vs. 22.0%). The one size fits all respirators including the DUO and Climax showed lower proportions of passing fit tests compared with AoSafety three-size system brands (2.40% and 4.90% vs. 29.30%). Low fit test passing rates were determined among different respirators. The respirators with various sizes and styles had more opportunities for different wearers to pass the fit test than single size models. The initial and annual fit testing requirements shall be developed by local government. Also, the manufacturers are required to pay attention to respirator features and subject characteristics during the production to obtain satisfactory protection for the end-users.
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