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

摘要 我们一直从事CHAMACOS研究(R01ES026994，Pi-Eskenazi)，这是一项纵向队列研究 600多个拉丁裔家庭，主要是农场工人(N=600个母子二人组，N=1200个) 加州萨利纳斯山谷已经有20多年了。这项研究的主要目的是调查 从子宫内到成年的生命过程中接触杀虫剂的后遗症。在这项建议中，我们的目标是研究 新冠肺炎疫情对这些家庭的影响。低收入家庭，特别是农场工人 考虑到狭窄的生活区，家庭感染新冠肺炎的比例可能会更高，这是他们的“必需品” 工作状态，乘坐拥挤的农工大巴上班，以及包装生产线上封闭的工作条件。在……里面 此外，大量流行病学和毒理学证据表明，杀虫剂，包括 有机磷、有机氯、氨基甲酸酯、拟除虫菊酯、除草剂草甘膦和 乙二硫代氨基甲酸酯(EBDC)杀菌剂可影响免疫抑制并增加敏感性 到传染病和更严重的疾病。出于这些原因，我们估计20%-40%的 CHAMACOS队列将在2021年1月之前感染。此外，我们假设CHAMACOS 鉴于贫困、就业不稳定、粮食短缺的风险，队列将受到大流行的更大影响， 移民身份，以及获得卫生服务的机会很少。对于600个母子二人组，我们收集了钥匙 大流行前关于健康、金融和粮食安全的信息，以及可能 已因大流行或感染风险增加而改变。本拟议补编的具体目的 是收集新冠肺炎后的数据，以评估健康变化(体重增加、血压升高、 焦虑或抑郁)，食物和住房保障，新冠肺炎或非新冠肺炎国家的医疗保健 相关条件，对移民当局的恐惧，在大流行期间保护行为的障碍(拥挤 住房、没有室内自来水、工作场所政策)和血清学SARS-CoV-2感染。我们将评估 累积接触杀虫剂是否会增加感染和疾病的风险。接触杀虫剂将是 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与20年住宅相联系 病史(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 儿童的暴露)。据我们所知，没有其他关于类似人群的研究，因为他们很难接触到 这群人的性质，现有数据的丰富性，以及我们与家属和 社区。因此，我们的提议将为了解感染新冠肺炎的高危人群提供一个难得的窗口 我们有独一无二的机会来了解这场流行病如何影响生活在 在农场工人社区工作是无与伦比的。

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.