COVID-19 Pandemic among low-income Latino families in an agricultural community: Financial, occupational, and mental and physical health sequelae

摘要 我们参与了CHAMACOS研究（R 01 ES 026994，PI-Eskenazi），这是一项纵向队列研究， 超过600个拉丁裔主要是农场工人的家庭（N=600个母子二人组，N=1200）， 萨利纳斯谷加州20多年。这项研究的主要目的是调查健康状况， 从子宫到成年的整个生命过程中接触农药的后遗症。在这项建议中，我们的目的是研究 COVID-19疫情对这些家庭的影响。低收入家庭，特别是农民工 家庭，可能会不成比例地受到COVID-19的感染，因为狭窄的生活区，他们的“基本” 工作状态，在拥挤的农场工人公共汽车上上班，以及包装线上的封闭工作条件。在 此外，大量的流行病学和毒理学证据表明， 有机磷（OP）、有机氯（OC）、氨基甲酸酯、拟除虫菊酯、除草剂草甘膦，以及 乙撑双二硫代氨基甲酸酯（EBDC）杀真菌剂可影响免疫抑制并增加易感性 传染病和更严重的疾病。基于这些原因，我们估计20%-40%的 CHAMACOS队列将在2021年1月之前被感染。此外，我们假设CHAMACOS 由于贫困、就业不安全、粮食短缺风险， 移民身份和难以获得保健服务。对于这600对母子，我们收集了 大流行病之前关于卫生、财政和粮食安全的信息，以及可能 已经被大流行或感染风险的增加所改变。本拟议补编的具体目标 收集COVID-19后的数据，以评估健康变化（体重增加、血压升高、 焦虑或抑郁），食品和住房安全，获得COVID-19或非COVID-19的医疗服务 相关条件，对移民当局的恐惧，大流行期间保护行为的障碍（拥挤） 住房、室内无自来水、工作场所政策）和SARS-CoV-2感染（血清学）。我们将评估 累积的农药暴露是否会增加感染和疾病的风险。农药的使用将 通过两种方式确定：通过使用加州独特的农药使用报告数据， 历史（儿童的一生）和使用现有的暴露生物标志物（包括产前和早期生活） 孩子的暴露）。据我们所知，由于难以接触， 这一群体的性质，现有数据的丰富性，以及我们与家庭的长期关系， 社区因此，我们的提议将为了解高风险感染COVID-19的人群提供一个难得的窗口 我们有独特的机会了解这一流行病如何影响生活在美国的低收入拉丁美洲家庭， 在农场工作是无与伦比的。

ABSTRACT We have been engaged in the CHAMACOS study (R01ES026994, PI-Eskenazi), a longitudinal cohort study of more than 600 Latino primarily farmworker families (N=600 mother-child dyads, N=1200) in the agricultural Salinas Valley California for 20+ years. The overaching aim of this study has been to investigate the health sequelae of pesticide exposure over the lifecourse from in utero to adulthood. In this proposal, we aim to study the impact of the COVID-19 pandemic on these families. Low-income families, and particularly farmworker families, will likely be disproportionately infected by COVID-19 given cramped living quarters, their “essential” work status, traveling to work in crowded farmworker buses, and close working conditions on packing lines. In addition, substantial epidemiologic and toxicologic evidence suggests that pesticides, including organophosphates (OPs), organochlorines (OCs), carbamates, pyrethroids, the herbicide glyphosate, and ethylenebisdithiocarbamate (EBDC) fungicides can impact immunologic suppression and increase susceptibility to infectious diseases and more severe disease. For these reasons, we estimate that between 20%-40% of the CHAMACOS cohort will have been infected by January 2021. In addition, we hypothesize that the CHAMACOS cohort will be more impacted by the pandemic given poverty, insecure employment, risk for food scarcity, immigration status, and poor access to health services. For the 600 mother-child dyads, we have collected key information prior to the pandemic on health, financial and food security, and other relevant variables that may have been altered by the pandemic or increased risk of infection. The specific aims of this proposed supplement are to collect data post-COVID-19 to assess change in health (weight gain, increase in blood pressure, increase in anxiety or depression), food and housing security, access to medical care for COVID-19 or non-COVID-19 related conditions, fear of immigration authorities, barriers to protective behaviors during the pandemic (crowded housing, no indoor running water, workplace policies), and SARS-CoV-2 infection by serology. We will assess whether cumulative pesticide exposure increased risk for infection and disease. Pesticide exposure will be determined in two ways: by using California’s unique Pesticide Use Reporting data linked to 20-year residential history (the lifetime of the child) and using existing biomarkers of exposure (including prenatal and early life exposure of the child). To our knowledge, there is no other study of a similar population given the hard-to-reach nature of this cohort, the richness of the existing data, and our long-term relationship with the families and the community. Thus, our proposal will give a rare window into a population at high-risk of contracting COVID-19 and our unique opportunity to understand how the pandemic affects low-income Latino families who are living and working in a farmworker community is unsurpassed.