While low back pain (LBP) is highly prevalent and potentially disabling, few intervention studies to mitigate LBP have been conducted in the labor-intensive agriculture sectors, and no evidence-based intervention studies exist specific to horticulture workers. In a preliminary study, horticulture workers in Florida reported a high incidence of opioid use attributed to work-related injury or stress. Given the challenges of deploying interventions in small teams, self-management offers an attractive and feasible option to address work-related risk factors and more effectively manage LBP. The primary purpose of this hybrid comparative effectiveness and implementation study is to investigate the effectiveness of self-management strategies to increase awareness of opioid risk, manage pain, and adjust work-related ergonomic risk to address this high-priority public health problem. The specific aims align with 1) NIOSH strategic goals to reduce musculoskeletal disorders related to lifting and physical repetitive stress, and 2) Healthy People 2030 objectives to increase self-management of chronic pain that frequently limits work activities. We are aiming to determine the effectiveness of self-management strategies, including ergonomic modifications using participatory methods for improving LBP among horticulture workers. We will investigate changes in prevalence of high-impact chronic pain, pain with work tasks, medication and substance use, and psychological factors. We aim to recruit 122 English and Spanish-speaking horticulture workers in Florida and randomly assign clusters (teams) to the two intervention groups. Short self-management video modules will introduce risks of opioid use, self-management of pain, and simple ergonomic strategies and participants will be asked to choose 1 self-management strategy and 1 workplace strategies. Surveys will be collected at baseline, pre- and post-intervention, with follow-ups at 3- and 6-months. Participants will be videoed performing work tasks to calculate the NIOSH lifting index and REBA risk factors for horticulture tasks. We will also identify contextual factors impacting engagement, adoption, effectiveness, and implementation. Interviews, focus groups, and field notes will be used to explain results and establish patterns to  inform future translation. Ultimately if either intervention is effective, mitigating pain positively impacts quality of life, productivity, and retention, and increasing non-pharmacological self-management addresses an important public health issue.  

The post Effectiveness and Implementation of Self-Management for Horticulture Workers  first appeared on Southeastern Coastal Center for Agricultural Health and Safety.

Chronic kidney disease of unknown etiology (CKDu) is an emerging public health concern for agricultural workers in various regions within the subtropics and tropics. Recognition of this condition is growing among agricultural communities and has been described in regions found in Central America, Sri Lanka, India, Tunisia, and Taiwan. The pathologic mechanisms leading to this form of nephropathy remain a mystery, but the process appears to be multifactorial. A combination of chronic heat stress and dehydration, prolonged exposure to agrochemicals and drinking water pollutants, and ongoing exposure to toxins produced by plants, microorganisms, and/or animals, have all been hypothesized to contribute to CKDu in agricultural communities. 

Research is needed to better understand those at-risk for this condition, and our multidisciplinary team will investigate the incidence and prevalence of CKDu among agricultural communities here in the state of Florida. Through our clinical networks, our team will analyze electronic health record and administrative claim data to examine occupational disparities in CKDu, geographical hotspots that may exist and develop a multi-level and geospatial model for CKDu risk factors in our state. 

The post Detection of Chronic Kidney Disease of Unknown Etiology in Florida by Repurposing a Statewide Data Infrastructure for Surveillance first appeared on Southeastern Coastal Center for Agricultural Health and Safety.

Agricultural workers provide the food we eat but often face a unique combination of occupational health hazards. Increasing incidence of unexplained chronic kidney disease in agricultural workers around the world, along with evidence from a recent Ag Health Study (AHS) in the U.S. directly linking kidney disease to exposure to specific pesticides, makes the study of chronic kidney disease in farmworkers an emerging high priority. Further concern exists that heat stress, another common environmental hazard in this sector, especially in the increasingly hot and humid climate of the southeast U.S., may exacerbate the effects of pesticide exposure on kidneys. There is a need for studies on the effects of pesticide exposure and heat stress, individually and combined, on kidney health.

This project will compare the effects of exposure to varying levels of three commonly used pesticides known to harm kidneys in rats over 14 days, compare the effects of hyperthermia and dehydration resembling heat stress endured by farmworkers on rats eight hours a day for 14 days, and compare the effects of each pesticide exposure with and without heat stress on kidneys in rats over 14 days. The project aims to establish a protocol for evaluating heat stress and pesticide exposure in animal studies, establish baseline data on the interaction between heat stress and pesticide exposure, and identify biological pathways affected by heat stress, pesticides, and both combined, and provide insight into molecular pathways leading to kidney damage.

The post Heat and Pesticide Stress in the Kidney first appeared on Southeastern Coastal Center for Agricultural Health and Safety.