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，尽管人们对农民工受伤和患病的严重程度知之甚少。他们就业的独特情况需要特别有针对性的监测系统来监测这一高危人群的伤害和疾病。本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、疾病症状的患病率和工作场所危害，并确定居住在德克萨斯州南部的农民工儿童及其家庭中这些不良健康结果的风险因素。本研究旨在通过计算机系统追踪美国（目前有10个州参与）格兰德城独立学区（位于德克萨斯州南部与墨西哥边境）的农民工儿童及其家庭。拟议的研究设计是一项为期两年的队列研究，从基线筛选调查开始，以确定移民意向和健康状况。将随机选择250个家庭，并要求他们在迁移过程中保持工作日记（根据随机研究方案）。一年级和二年级结束后，母亲们回到里约热内卢Grande City后，将会收到一份调查问卷。调查表将征求有关可能预测伤害和疾病的病原体、宿主和环境风险因素的信息（例如，人口、工作、社会心理、医疗保健、儿童保育和伤害和疾病问题）。还将从这一人群中抽取子样本，以检查一致性问题（例如，母亲/孩子与丈夫/妻子之间的反应是否一致）。将召集一个来自德克萨斯/墨西哥边境社区和学术界的咨询小组，就有关问题向研究提供咨询意见，并建立一个联盟，以持续监测社区关注的问题和解决这一人口中受伤和其他健康状况的方法。将这项研究作为监测实施的原型，可能对接触和监测该国大部分移民农场工人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.