INJURY AND ILLNESS SURVEILLANCE IN MIGRANT FARMWORKERS

农业是美国和德克萨斯州最危险的行业之一，尽管人们对外来农场工人人口的受伤和疾病程度知之甚少。他们就业的独特情况要求有专门的监测系统来监测这一高危人群中的伤害和疾病。这项研究的总体目标是建立一个监测系统，估计职业伤害的发生率、疾病症状和工作场所危害的流行率，并确定居住在南得克萨斯州的外来务工儿童及其家庭中这些不良健康后果的危险因素。这项研究建议通过一个计算机化系统来确定里奥格兰德市独立学区(德克萨斯州南部，德克萨斯州和墨西哥边境)的外来务工人员子女及其家人，该系统旨在跟踪这些学生在美国各地的上学进展(目前有10个州参与)。拟议的研究设计是一项为期两年的队列研究，首先在基线进行筛查调查，以确定移徙意向和健康状况。250个家庭将被随机选择，并将被要求在迁移期间保留工作日记(根据随机研究方案)。在第一年和第二年回到里奥格兰德市后，将向母亲发放一份问卷。问卷将征求可能预测伤害和疾病的代理人、东道主和环境风险因素的信息(例如，人口、工作、心理社会、医疗保健、儿童护理以及伤害和疾病问题)。还将从这一人群中抽取次级样本，以审查协议问题(例如，母亲/孩子和丈夫/妻子之间的反应是否一致)。将组建一个来自德克萨斯州/墨西哥边境社区和学术界的咨询小组，就相关问题向研究提供建议，并建立一个联盟，不断监测社区关注的问题和解决这一人群受伤和其他健康问题的方法。将这项研究作为监测执行工作的原型，可能会对获取和监测该国很大一部分外来务工儿童及其家庭的危害和健康结果以及评估未来干预措施的能力产生深远影响。

Agriculture is one of the most hazardous industries in the U.S. and in Texas, although little is known about the magnitude of injury and illness in the migrant farmworker population. The unique circumstances of their employment require specially targeted surveillance systems to monitor for injuries and illnesses in this high-risk population. The overall goal of this study is to develop a surveillance system and estimate the incidence rate of occupational injuries, the prevalence of illness symptoms and workplace hazards, and to identify risk factors for these adverse health outcomes in a population of migrant farmworker children and their families residing in South Texas. This study proposes to ascertain migrant farmworker children and their families in Rio Grande City Independent School District (in South Texas along the Texas-Mexico border) through a computerized system designed to track school progress of these students across the U.S. (10 states currently participate). The proposed study design is a two-year cohort study beginning with a screening survey at baseline to ascertain intention to migrate and health status. Two-hundred fifty families will be selected randomly and will be asked to maintain a work diary while migrating (according to a randomized study protocol). A questionnaire will be administered to the mothers upon return to Rio Grande City after Year 1 and Year 2. The questionnaire will solicit information on agent, host, and environment risk factors that may predict injury and illnesses (e.g., demographic, work, psychosocial, medical care, childcare, and injury and illness questions). Subsamples from this population will also be taken to examine agreement issues (e.g., concordance of responses between mother/child and husband/wife). An advisory group from the Texas/Mexico border community and the academic communities will be assembled to advise the study on relevant issues and to build a coalition for ongoing monitoring of community concerns and ways to address injuries and other health conditions in this population. Using this study as a prototype for surveillance implementation could have a profound impact on the ability to access and monitor a large portion of migrant farmworker children and their families in this country for hazards and health outcomes as well as to evaluate future interventions.