Joan Flocks

Florida Farmworkers’ Perceptions and Lay Knowledge of Occupational Pesticides

Despite federal regulations, farmworkers often lack access to basic information about pesticides applied at their worksites. Focus groups revealed that farmworkers have developed an extensive body of lay knowledge, based on personal perceptions, about pesticides and pesticide exposure including means of pesticide exposure, means of pesticide entry into the body, and the potential health effects of pesticide exposure. We describe how this lay knowledge, when combined with technical information that is required to be provided to workers by law, provides valuable data to consider before developing and implementing health interventions designed to reduce the adverse health effects of pesticide exposure.

Female Farmworkers’ Perceptions of Pesticide Exposure and Pregnancy Health

Occupational pesticide exposure may be hazardous to pregnant farmworkers, yet few studies have focused on the health of female farmworkers distinct from their male counterparts or on the impact of agricultural work tasks on pregnancy outcomes. In the current community-based participatory research study, researchers conducted five focus groups with female nursery and fernery workers in Central Florida to enhance knowledge of attitudes about occupational risks and pregnancy health and to gather qualitative data to help form a survey instrument. This article presents the results from questions focused on pesticide exposure and its impact on general, reproductive, pregnancy, and fetal health. Workers reported a belief that pesticide exposure could be hazardous to pregnancy health; descriptions of symptoms and health concerns believed to be related to farmwork and to pesticide exposure; and descriptions of barriers preventing them from practicing safer occupational behaviors.

Community-Based Social Marketing: Involvement in Health Programs

Social marketing is a strategy that uses marketing approaches developed within the business arena to design, implement, and evaluate socially beneficial programs. This approach can be an effective social change strategy for groups working in the profession of community development. This paper describes two community-based projects that employed social marketing to design and implement interventions to promote health in Arkansas and Florida. We describe the stages of the research, as well as the limitations and strengths of this approach.

Stakeholder Analysis of Florida Farmworker Housing

Abstract Farmworkers, farmworker advocates, state and federal policy-makers, and researchers all consider adequate housing as central to successful migration, community building, and quality of life, including good health, among farmworkers. This study analyzes results from interviews and focus groups with stakeholders involved in Florida farmworker housing conducted with the goal of providing recommendations for future farmworker housing policy. These recommendations include considering housing needs within a life continuum and understanding how wages and housing are interconnected. The concurring perspectives of stakeholders can be considered as building blocks in developing more effective state and local housing policy.

Pesticide Risk Perception and Biomarkers of Exposure in Florida Female Farmworkers

Objective: To compare workplace characteristics, workplace behaviors, and the health beliefs of female farmworkers of childbearing age with actual biomarkers of exposure to organophosphate pesticides and to the fungicide mancozeb. Methods: Hispanic and Haitian farmworkers between the ages of 18 and 40 years working in nursery or fernery operations were recruited to participate in a cross-sectional survey, examining demographics, work practices, work-related hygiene, and pesticide exposure beliefs. Single-void (spot) urine samples were analyzed for organophosphate and ethylenethiourea metabolites. Results: Women in nurseries worried less frequently about the effects of pesticides on their health than those in fernery operations. In summary, organophosphate and ethylenethiourea levels in nursery workers were significantly higher than levels in fernery workers and the control group. Conclusions: Results showed that perceived pesticide exposure did not correspond to actual metabolite levels within differing agricultural subpopulations.

Female Farmworkers’ Perceptions of Heat-Related Illness and Pregnancy Health

ABSTRACT Although agricultural workers have elevated risks of heat-related illnesses (HRI), pregnant farmworkers exposed to extreme heat face additional health risk, including poor pregnancy health and birth outcomes. Qualitative data from five focus groups with 35 female Hispanic and Haitian nursery and fernery workers provide details about the womens perceptions of HRI and pregnancy. Participants believe that heat exposure can adversely affect general, pregnancy, and fetal health, yet feel they lack control over workplace conditions and that they lack training about these specific risks. These data are being used to develop culturally appropriate educational materials emphasizing health promoting and protective behaviors during pregnancy.

A systematic review of Mancozeb as a reproductive and developmental hazard.

BACKGROUND The potential adverse reproductive and developmental effects of Mancozeb, especially in sensitive subpopulations, have not been fully reviewed for this widely used fungicide. OBJECTIVE To review the experimental and epidemiologic evidence for the association between exposure to Mancozeb and reproductive and developmental health outcomes using an adaptation of the National Toxicology Programs Office of Health Assessment and Translation (OHAT) systematic review framework. DATA SOURCES Four databases (PubMed, TOXNET, Web of Science, Google Scholar) were searched for published studies on Mancozeb. Of 403 identified articles, 30 met our inclusion criteria for systematic review. RESULTS Results from in vitro studies provide evidence that Mancozeb may indirectly disrupt or impair reproduction at the cellular level and should be regarded as a reproductive toxicant. Animal studies confirm reproductive and developmental toxicity in mammals and suggest that males chronically exposed to Mancozeb experience significant changes in physiological, biochemical, and pathological processes that may lead to infertility. Epidemiological studies were limited to indirect methods of exposure assessment and examined the effect of fungicides more broadly during pre-conception, pregnancy, and birth, yielding mixed results. CONCLUSIONS High confidence ratings from in vitro and animal studies, in combination with moderate confidence ratings from epidemiologic studies employing indirect methods of exposure assessment, provide evidence that Mancozeb should be regarded as a suspected developmental hazard and a presumed reproductive hazard in humans. More population-based studies linking direct measures and/or biomarkers of exposure to adverse effects on male and female fertility, as well as in utero and early life development, are needed to improve the quality of the evidence base concerning the human reproductive and developmental consequences of Mancozeb exposure.

Heat Exposure in Central Florida Fernery Workers: Results of a Feasibility Study

ABSTRACT Objective: The objective of this study was to determine the feasibility of field-based biomonitoring of heat-related illness (HRI) phenomena in Florida farmworkers. The authors determined feasibility through participant interviews regarding acceptability, data capture, recruitment and retention, and observed barriers and challenges to implementation. Methods: Study participants were employed in fernery operations in northeast Central Florida where ornamental ferns are grown and harvested in a seasonally high-heat environment. In this pilot, a total of 43 farmworkers participated during summers 2012 and 2013 and measurements included body core temperature, heart rate, energy expenditure, urine and blood osmolality, and self-reported HRI symptoms. Results: Data capture was approximately 90%. Participants reported that the study methods were nonobtrusive to their work, and that they were comfortable with study measures. Conclusions: These results open possibilities for characterizing HRI utilizing physiologic biomonitoring in vulnerable occupational groups.

Novel Analytic Methods Needed for Real-Time Continuous Core Body Temperature Data

Affordable measurement of core body temperature (Tc) in a continuous, real-time fashion is now possible. With this advance comes a new data analysis paradigm for occupational epidemiology. We characterize issues arising after obtaining Tc data over 188 workdays for 83 participating farmworkers, a population vulnerable to effects of rising temperatures due to climate change. We describe a novel approach to these data using smoothing and functional data analysis. This approach highlights different data aspects compared with describing Tc at a single time point or summaries of the time course into an indicator function (e.g., did Tc ever exceed 38 °C, the threshold limit value for occupational heat exposure). Participants working in ferneries had significantly higher Tc at some point during the workday compared with those working in nurseries, despite a shorter workday for fernery participants. Our results typify the challenges and opportunities in analyzing Big Data streams from real-time physiologic monitoring.

Collecting Comparative Data on Farmworker Housing and Health: Recommendations for Collecting Housing and Health Data Across Places and Time.

The substandard nature of the housing in which most farmworkers live has detrimental effects on their health, as well as on their children’s health and development. However, little research has directly documented associations between farmworker housing and health; existing research is not always comparable due to differences in design and measurement. Comparative data can help determine actual causal links between housing characteristics and farmworker health and help to evaluate the efficacy of current housing policy. The goal of this paper is to provide guidelines promoting comparable research on farmworker housing and the association of this housing with health. This paper reviews general concepts relevant to measuring farmworker housing and health, issues that should be considered in designing farmworker housing and health research, data collection methods, and measures. It concludes with recommendations for a research agenda on farmworker housing and health.