DrPH Stanley H. Schuman Md

Ergonomics in Agriculture

“Ergonomics in Agriculture?” It sounds like a far-fetched idea, or a concept ahead of its time, even in the 21st century. Can agricultural ergonomics be defined, as part of the art and science of producing a crop in a safe way, for the benefit of the consumer and health of the worker? It sounds simple, especially in our age of revolutionary advances in every occupational and medical field (orthopedics, physical medicine and rehabilitation, industrial medicine, sports medicine, etc.). But how can the basic science of ergonomics be applied to so many agricultural practices, in so many differing countries and cultures, economies and traditions? Take, for instance, the repetitious tasks required in the vineyard: planting, pruning, harvesting, weeding and soil preparation, hauling the crop from vine to processing, and last, but not least, maintaining the well-being of the field workers, with a minimum of lacerations, strains of the spine and upper and lower extremities, and a minimum of heat or cold injury, exhaustion, and mental stress. Surely, after all these centuries of cultivating berries and grapes, we must have evolved the most productive and least hazardous ways of achieving a crop. Perhaps, but in this issue of the Journal a team of scientists from California focus our attention on the simple, yet complex, series of jobs required in one form of agricultural field work. Meyers and co-workers introduce us to the methodology of defining each task, each repetition, each cycle, each time-unit of labor, controlling interobserver error, and interviewing workers for their self-assessment of the most arduous tasks. The starting point of the California study is the high rate of musculoskeletal disorders, especially lower back strain, documented among vineyard workers at three cooperating operations in Napa and Sonoma Counties. Building on their prior studies for preventing musculoskeletal injury in plant nurseries, the California researchers obtained NIOSH support and employer cooperation for their field study. They used a variety of sources of information to measure the impact of vineyard field work on sprain and strain injuries:

Agromedicine and Emerging Infectious Diseases

In 1959 I entered the School of Public Health at the University of Michigan as a post-doctoral fellow in epidemiology. Despite serving two years in infectious diseases in the U.S. Public Health Service and in spite of six years of ambulatory pediatrics, I listened to some of the most eminent leaders in public health who warned me that a meaningful career should focus on chronic diseases, not “old fashioned” infectious diseases. Nationwide, federal funds were being diverted from clinicians and laboratories, sanitarians and engineers, to focus on the prevention and control of heart disease, cancer, and stroke. What with the “miraculous” antibiotics available, and advances in sanitary practices, the “war” against microbes was won (finis!). Fortunately, in retrospect, a thin line of dedicated microbiologists stuck to their microscopes and continued to explore the complex world of human parasites, viruses, and bacteria, host defenses, barriers to transmission and improved vaccines. Such scientists knew that microbes of all kinds possessed opportunistic ways to survive and thrive in human settings. Now, in 2001, infectious diseases are in the forefront of urgent problems of increased frequency, severity, and worldwide distribution. Antibiotic resistance keeps emerging in veterinary, medical, and hospital practice. International exchanges of hoof-and-mouth disease in livestock, persistence of BSE prions in animals and asymptomatic humans, and outbreaks of water-and-food related gastrointestinal illness–all command our attention, and require renewed techniques and technologies to keep up with our adaptive microbial cousins, life-forms that preceded mankind and may outlive us. Ever since its first issue in 1974, the peer-reviewed journal, Emerging Infectious Diseases, has fulfilled its mission, “to track and analyze infectious disease trends.” Based at the Centers for Disease Control and Prevention in Atlanta, GA, the journal has seven U.S. editors, nine international editors, and an editorial board of 61 experts from diverse

The Challenge and Impact of Field Studies in Agromedicine

In te grated pest man age ment (IPM) and ap plied med i cal ep i de mi ol ogy (AME) are not that dif fer ent in im por tance to hu man health and nu tri tion. Both sci ences de pend on in te grat ing a va ri ety of skills and in ves ti ga tional tools. Both IPM and AME try to keep up with the ever-chang ing ecol ogy of par a sites and mi crobes as they im pact the well-be ing of plants, live stock, and hu mans. In this is sue, Shepard and col leagues re port on a se ries of their IPM field stud ies. The team ap proach is ev i dent in the ap pli ca tion of en to mol ogy, plant pa thol ogy, vi rol ogy and clas sic ex ten sion ed u ca tion meth ods (train the trainer) in help ing In do ne sian peas ants pro duce their so-called sec ond ary crops (soy bean, cab bage, shal lots, chil ies, and long bean). A “sec ond ary” crop for a farmer in a de vel oped coun try could rep re sent a sub sis tence crop for a hun gry vil lager in a de vel op ing coun try. Not too long ago in the United States, the poor strug gled to get through the Great De pres sion years with small plots of “sec ond ary” fruits and veg e ta bles. In fact, the malnutritional dis ease of pel la gra got a foot hold in the South when a gen er a tion of tex tile work ers for sook their gar den plots or for got how to hoe, weed, and plant es sen tial pro duce in their back yards. In stead, poor South erners be gan to rely on cheap pro cessed foods ob tained at the coun try store. Year af ter year, fam i lies sur vived dur ing the win ters on a mo not o nous diet of pro cessed maize, fat back, and mo las ses that lacked the es sen tial nu tri ents of ni a cin and trypto phane. As a re sult of lack of sec ond ary pro duce in the diet, pel la gra reached ep i demic pro por tions in the South ern states, fill ing hos pi tals and men tal in sti tu tions with un ex plained cases of the three “D’s”: Der ma ti tis, Di ar rhea, and De men tia. Epidemiologists thought it was caused by an in fec tious dis ease, re sem bling the de bil i tat ing signs of chronic ty phus, be fore a ded i cated U.S. Pub lic Health Ser vice phy si cian, Jo seph Goldberger, un rav eled the mys te ri ous ill ness. It took years of his keen