Assessing Heat-Related Morbidity among Migrant and Seasonal Farmworkers

项目摘要 极端高温是一个主要的公共卫生问题，造成的死亡人数超过其他与天气有关的原因 在美国，农场工人很容易受到极端高温的影响，因为近85%的美国农场工人 户外，他们通常从事繁重的工作，例如，与高温有关的死亡率 农业/林业/渔业和狩猎业在所有工业部门中所占比例最高。预计 热浪的频率和强度的增加以及劳动力的老龄化， 在不断变化的气候中，农业工人更容易受到热压力的影响。移民和季节性农场工人 他们可能比其他工人更容易受到高温的影响，因为贫困，有限的健康保险覆盖范围， 未经授权的工作状态可能会加剧他们的脆弱性。然而，据我们所知， 量化了极端高温与移民和季节性高温相关疾病之间的关联， 美国农场工人使用医疗记录和评估潜在的脆弱性指标。我们的长期 我们的目标是减少美国移民和季节性农场工人的热相关健康影响。 独特的准备，以实现这一目标，因为我们可以利用资源，从第一纵向医疗 记录数据库（基于社区的研究网络[CBRN]）在移民和季节性农场工人， 具体来说，我们建议：1）确定是否过剩的情况下，所有的原因和原因具体 （心血管、呼吸道、糖尿病、肾脏和与热有关的原因）疾病发生在移民和 在炎热的日子里，CBRN中包括季节性农场工人; 2）评估脆弱性的潜在决定因素 通过评估是否热发病率协会不同，根据农场工人的地位，个人 特点和地理区域。这个项目解决了一个重要的，但很少研究极端热- 这是一个与脆弱人群相关的公共卫生问题，并对许多其他户外工作者产生影响。 这项具有高度时间和成本效益的研究将是第一个调查移民与热有关的疾病， 这项研究的结果可以帮助支持证据- 基于政策制定，制定和评估有针对性的干预措施， 农业部门急需的职业伤害和疾病。这项工作符合 国家职业研究议程确定的与农业部门有关的优先事项 中期目标5.4.这项研究有助于NIOSH的研究实践（r2 p）倡议， 向主要利益攸关方传播研究成果。

Project Abstract Extreme heat is a major public health problem that has caused more deaths than other weather related causes in the U.S. Farmworkers are vulnerable to extreme heat because nearly 85% of U.S. farmworkers labor outdoors and they are usually engaged in heavy work, e.g., the rate of heat-related deaths in the agriculture/forestry/fishing and hunting industry was the highest among all industry sectors. Projected increases in the frequency and intensity of heat waves together with an aging workforce are expected to worsen vulnerabilities of farmworkers to heat stress in a changing climate. Migrant and seasonal farmworkers are likely more vulnerable to heat than other workers because poverty, limited health insurance coverage and unauthorized work status might exacerbate their vulnerability. However, to our knowledge, no studies have quantified the associations between extreme heat and heat-related illness among migrant and seasonal farmworkers in the U.S. using medical records and evaluated potential vulnerability indicators. Our long-term goal is to reduce heat-related health effects for migrant and seasonal farmworkers in the U.S. We are uniquely poised to achieve this goal because we can leverage resources from the first longitudinal medical records database (Community Based Research Network [CBRN]) among migrant and seasonal farmworkers in the U.S. Specifically, we propose: 1) to determine whether excess cases of all-cause and cause-specific (cardiovascular, respiratory, diabetes, renal and heat-related causes) illness occur among migrant and seasonal farmworkers included in CBRN on hot days; and 2) to evaluate potential determinants of vulnerability by assessing whether heat-morbidity associations differ, according to farmworker status, individual characteristics, and geographic areas. This project addresses a significant, but rarely studied extreme heat- related public health problem in a vulnerable population, and has implications for many other outdoor workers. This highly time- and cost-effective study will be the first to investigate heat-related illness on migrant and seasonal farmworkers using medical records in the U.S. The results of this study can help support evidence- based policy development, develop and evaluate targeted interventions, and improve surveillance of occupational injuries and illnesses that is greatly needed in the agriculture sector. The work is consistent with priorities identified by the National Occupational Research Agenda related to the Agriculture sector Intermediate Goal 5.4. This research contributes to the NIOSH research-to-practice (r2p) initiative by disseminating the research results to key stakeholders.