Jo Anne G. Balanay

Sun Safety Among Farmers and Farmworkers: A Review

ABSTRACT Farmers and farmworkers face increased risks of skin cancer from exposure to solar ultraviolet radiation (UVR) when working outdoors. The objective of this study was to evaluate the evidence from behavioral and intervention studies from the peer-reviewed studies related to sun safety among farmers and farmworkers and identify any gaps in the literature. A comprehensive review was conducted between 1990 and 2013; 22 studies were identified related to behavior and health interventions of sun safety among these targeted groups. The inconsistency of data collection methods makes it difficult to estimate with accuracy any overall meaningful results of behavior. However, from the studies reviewed, farmers and farmworkers most frequently reported wearing some type of hat (23.6%–100%) as a primary method of protection from the sun when working outdoors. Female farmers were more likely than male farmers to use sunscreen and engage in indoor tanning behavior. All sun safety educational interventions studies reviewed reported positive increases in behavioral change. To a large degree, adequate sun protection is lacking and varies geographically among farmers. Although targeted education is key to making improvements on sun protection behavior, aggressive attempts have to be made. Studies related to farmworkers, sun safety behavior, and skin cancer are scarce and more research is needed in this area.

Assessment of Sun Safety Behavior among Farmers Attending a Regional Farm Show in North Carolina

ABSTRACT Background: Due to the nature of working outdoors, many farmers experience high levels of exposure to ultraviolet radiation (UVR) whereby, increasing their risk for skin cancer. The primary goal of this study was to evaluate personal behavior and perception on sun protection among farmers attending a regional farm show in North Carolina. Methods: Farmers (n = 397) were asked to complete a self-administered questionnaire regarding behavior and importance of using personal sun protection (i.e., sunblock, etc.,) when working outdoors. Results: There were 285 (71.8%) male farmers and 79 (19.9%) female farmers with a mean age of 54 years. Overall, the majority of farmers recognized the importance of protecting themselves from the sun, however, actual personal behavior for using proper protection methods ranked low. Farmers with lighter, fairer skin tended to use more sun protection and ranked the importance of sun protection higher when compared to those with skin that was less likely to burn in the sun. Conclusion: The importance of personal sun protection should continue to be stressed to farmers at every available opportunity including farm shows, trainings and through health care providers.

Comparison of toluene adsorption among granular activated carbon and different types of activated carbon fibers (ACFs).

Activated carbon fiber (ACF) has been demonstrated to be a good adsorbent for the removal of organic vapors in air. Some ACF has a comparable or larger surface area and higher adsorption capacity when compared with granular activated carbon (GAC) commonly used in respiratory protection devices. ACF is an attractive alternative adsorbent to GAC because of its ease of handling, light weight, and decreasing cost. ACF may offer the potential for short-term respiratory protection for first responders and emergency personnel. This study compares the critical bed depths and adsorption capacities for toluene among GAC and ACF of different forms and surface areas. GAC and ACF in cloth (ACFC) and felt (ACFF) forms were challenged in stainless steel chambers with a constant concentration of 500 ppm toluene via conditioned air at 25°C, 50% RH, and constant airflow (7 L/min). Breakthrough data were obtained for each adsorbent using gas chromatography with flame ionization detector. Surface areas of each adsorbent were determined using a physisorption analyzer. Results showed that the critical bed depth of GAC is 275% higher than the average of ACFC but is 55% lower than the average of ACFF. Adsorption capacity of GAC (with a nominal surface area of 1800 m2/g) at 50% breakthrough is 25% higher than the average of ACF with surface area of 1000 m2/g, while the rest of ACF with surface area of 1500 m2/g and higher have 40% higher adsorption capacities than GAC. ACFC with higher surface area has the smallest critical bed depth and highest adsorption capacity, which makes it a good adsorbent for thinner and lighter respirators. We concluded that ACF has great potential for application in respiratory protection considering its higher adsorption capacity and lower critical bed depth in addition to its advantages over GAC, particularly for ACF with higher surface area.

Estimating the Prevalence of Heat-Related Symptoms and Sun Safety–Related Behavior among Latino Farmworkers in Eastern North Carolina

ABSTRACT In hot weather, thermal heat generated by the body, combined with environmental heat from the sun, can lead outdoor workers to experience heat-related stress, severe illness, or even death. The aims of this study were to estimate the prevalence of heat-related symptoms and potential risk factors associated with sun safety–related behavior among Latino farmworkers. Data from interviewer-administered questionnaires were collected from a cross-sectional survey among farmworkers (N = 158) from August to September 2013. Data analysis assessed associations between work activities, sun safety behavior, and the prevalence of heat-related illness (HRI) symptoms among workers. Nearly two thirds (72%) of farmworkers experienced at least one HRI symptom and lacked proper cooling methods when working outdoors. Most workers reported wearing long-sleeved shirts (85%), long pants (98%), and baseball caps (93%). The prevalence of having one HRI symptom was 72% and 27% among workers having three or more HRI symptoms. The majority of farmworkers experience symptoms of HRI and are not provided with proper shade protection when working outdoors. Increased emphasis on administrative controls, particularly educating field supervisors and workers on how to avoid and recognize HRI, should be a priority.

Assessment of Personal Protective Equipment Use Among Farmers in Eastern North Carolina: A Cross-sectional Study

ABSTRACT Agriculture consistently ranks among the top hazardous occupations, accounting for a significant number of injuries and fatalities in the workplace. Eastern North Carolina has a significant number of small, independent, family-run, owned, and operated farms. However, little is known about perception, behavior, training, accessibility, or purchasing personal protective equipment (PPE) for safety among farmers in the region. In this study, telephone interviews were conducted among participating farmers between March and June 2012 (N = 129). Univariate and bivariate analyses were conducted to examine associations between PPE behavior and workplace hazards, health-related concerns, and wearing and purchasing PPE. Findings indicated that personal behavior of wearing hearing protection devices (HPDs) and protection from the sun among farmers was low. However, a relatively high percentage of farmers reported wearing PPE when working with agricultural chemicals. Most farmers received training from agricultural extension offices. The findings indicate that, in general, farmers are well aware of the risks associated with occupational hazards and recognize concern for health and safety protection in the workplace. Transitioning these concerns into preventative action remains a challenge and priority for the agricultural health professional.

Adsorption Characteristics of Activated Carbon Fibers (ACFs) for Toluene: Application in Respiratory Protection

Granular activated carbon (GAC) is currently the standard adsorbent in respirators against several gases and vapors because of its efficiency, low cost, and available technology. However, a drawback of GAC due to its granular form is its need for containment, adding weight and bulkiness to respirators. This makes respirators uncomfortable to wear, resulting in poor compliance in their use. Activated carbon fibers (ACF) are considered viable alternative adsorbent materials for developing thinner, light-weight, and efficient respirators because of their larger surface area, lighter weight, and fabric form. This study aims to determine the critical bed depth and adsorption capacity of different types of commercially available ACFs for toluene to understand how thin a respirator can be and the service life of the adsorbents, respectively. ACF in cloth (ACFC) and felt (ACFF) forms with three different surface areas per form were tested. Each ACF type was challenged with six concentrations of toluene (50, 100, 200, 300, 400, 500 ppm) at constant air temperature (23°C), relative humidity (50%), and airflow (16 LPM) at different adsorbent weights and bed depths. Breakthrough data were obtained for each adsorbent using gas chromatography with flame ionization detector. The ACFs’ surface areas were measured by an automatic physisorption analyzer. The results showed that ACFC has a lower critical bed depth and higher adsorption capacity compared to ACFF with similar surface area for each toluene concentration. Among the ACF types, ACFC2000 (cloth with the highest measured surface area of 1614 ± 5 m2/g) has one of the lowest critical bed depths (ranging from 0.11–0.22 cm) and has the highest adsorption capacity (ranging from 595–878 mg/g). Based on these studied adsorption characteristics, it is concluded that ACF has great potential for application in respiratory protection against toluene, particularly the ACFC2000, which is the best candidate for developing thinner and efficient respirators.

Baseline Insecticide Susceptibility Screening Against Six Active Ingredients for Culex and Aedes (Diptera: Culicidae) Mosquitoes in the United States

Abstract Mosquitoes may develop resistance to insecticide active ingredients (AI). Thus, mosquitoes should be tested for resistance to confirm efficacy of insecticide-based control, inform management decisions, and protect public and environmental health. Our objectives were to determine a baseline of resistance for six AIs used in mosquito control in the United States to assess how resistance differs between mosquito collection location, AI, and mosquito species (container-ovipositing Aedes and Culex that may oviposit in containers or other sources). Field-collected eggs from 26 mosquito populations of five different species or hybrid species (Aedes albopictus Say, Aedes triseriatus Say, Culex pipiens L., Culex quinquefasciatus Say, Culex pipiens/quinquefasciatus) were obtained from four regions across the United States. Centers for Disease Control and Prevention bottle bioassays were used to determine baseline resistance and susceptibility status for six AIs (bifenthrin, deltamethrin, etofenprox, malathion, permethrin, and phenothrin). World Health Organization guidelines were used to classify mosquitoes as susceptible (98–100% mortality at diagnostic time [DT]), possibly resistant (80–97% mortality at DT), or resistant (< 80% mortality at DT). Aedes spp. mosquitoes were less likely to exhibit resistance, compared with Culex spp. mosquitoes. A high degree of resistance to etofenprox and malathion was observed (4–26-fold greater resistance to these two AIs compared with the other examined AIs). Baseline data on resistance and susceptibility for mosquitoes exposed to commonly used insecticides may help us evaluate resistance trends and highlight the importance of assessing local resistance trends before insecticide-based control measures are implemented.

Eastern Carolina Asthma Prevention Program (ECAPP): An Environmental Intervention Study among Rural and Underserved Children with Asthma in Eastern North Carolina:

Objective Asthma is the most common chronic childhood condition affecting 6.3 million (US) children aged less than 18 years. Home-based, multi-component, environmental intervention studies among children with asthma have demonstrated to be effective in reducing asthma symptoms. In this study, a local hospital and university developed an environmental intervention research pilot project, Eastern Carolina Asthma Prevention Program (ECAPP), to evaluate self-reported asthma symptoms, breathing measurements, and number of asthma-related emergency department (ED) visits among low-income, minority children with asthma living in rural, eastern North Carolina. Our goal was to develop a conceptual model and demonstrate any asthma respiratory improvements in children associated with our home-based, environmental intervention. Methods This project used a single cohort, intervention design approach to compare self-reported asthma-related symptoms, breathing tests, and ED visits over a 6 month period between children with asthma in an intervention study group (n = 12) and children with asthma in a control study group (n = 7). The intervention study group received intense asthma education, three home visits, 2 week follow-up telephone calls, and environmental intervention products for reducing asthma triggers in the home. The control group received education at baseline and 2 week calls, but no intervention products. Results At the end of the study period, significant improvements were observed in the intervention group compared with the control group. Overall, the intervention group experienced a 58% (46 ± SD 26.9) reduction in self-reported asthma symptoms; 76% (34 ± SD 29.7) decrease in rescue medicine; 12% (145 ± SD 11.3) increase in controller medicine; 37% decrease in mean exhaled nitric oxide levels and 33% fewer ED asthma-related visits. Conclusion As demonstrated, a combination of efforts appeared effective for improving asthma respiratory symptoms among children in the intervention group. ECAPP is a low cost pilot project that could readily be adapted and expanded into other communities throughout eastern North Carolina. Future efforts could include enhanced partnerships between environmental health professionals at local health departments and pediatric asthma programs at hospitals to carry out ECAPP.

Attitudes toward noise, perceived hearing symptoms, and reported use of hearing protection among college students: Influence of youth culture.

The purpose of this study was to assess the attitude toward noise, perceived hearing symptoms, noisy activities that were participated in, and factors associated with hearing protection use among college students. A 44-item online survey was completed by 2,151 college students (aged 17 years and above) to assess the attitudes toward noise, perceived hearing symptoms related to noise exposure, and use of hearing protection around noisy activities. Among the participants, 39.6% experienced at least one hearing symptom, with ear pain as the most frequently reported (22.5%). About 80% of the participants were involved in at least one noise activity, out of which 41% reported the use of hearing protection. A large majority of those with ear pain, hearing loss, permanent tinnitus, and noise sensitivity was involved in attending a sporting event, which was the most reported noisy activity. The highest reported hearing protection use was in the use of firearms, and the lowest in discos/ dances. The reported use of hearing protection is associated with having at least one hearing symptom but the relationship is stronger with tinnitus, hearing loss, and ear pain (χ 2 = 30.5-43.5, P< 0.01) as compared to noise sensitivity (χ 2 = 3.8, P= 0.03); it is also associated with anti-noise attitudes, particularly in youth social events. Universities and colleges have important roles in protecting young adults′ hearing by integrating hearing conservation topic in the college curriculum, promoting hearing health by student health services, involving student groups in noise-induced hearing loss (NIHL) awareness and prevention, and establishing noise level limitations for all on-campus events.

Evaluation of bifenthrin barrier spray on foliage in a suburban eastern North Carolina neighborhood

BACKGROUND Mosquitoes can transmit pathogens through blood feeding. Mosquito control programs conduct surveillance and source reduction, treat mosquito oviposition sites and spray adulticides to protect public health. In some areas, homeowners may contract with private mosquito control companies to address mosquito-related issues. RESULTS We evaluated the efficacy of barrier sprays by comparing weekly host-seeking mosquito abundance at treatment and control properties in a residential neighborhood. The chemical concentration of bifenthrin residue on foliage was quantified, and field-collected mosquitoes, primarily Aedes albopictus, were tested for bifenthrin resistance using bottle bioassays. Mosquito abundance at treatment properties was significantly (P < 0.05) lower than at control properties. Quantities of bifenthrin detected on foliage from treatment properties was not correlated with mosquito abundance. No bifenthrin resistance was detected in captured mosquitoes. CONCLUSION Based on the rate of application, we expected that chemical analysis of bifenthrin residue would show similar concentrations of bifenthrin on foliage in treatment areas. Although mosquitoes were not bifenthrin resistant, further studies are needed to evaluate the extent to which resistance changes over time with repeated applications. Findings from this study provide insight into control methods commonly used by mosquito control companies and could potentially be used to guide future mosquito management strategies.