Assessing Heat-Related Morbidity among Migrant and Seasonal Farmworkers

项目摘要 酷暑是一个主要的公共卫生问题，它导致的死亡人数超过了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 他们通常在户外从事繁重的工作，例如，在 农业/林业/渔业和狩猎业是所有工业部门中最高的。预计 热浪频率和强度的增加以及劳动力老龄化预计将 加剧了农场工人在气候变化中对热应激的脆弱性。外来务工人员和季节性农场工人 可能比其他工人更容易受到高温的影响，因为贫困、有限的医疗保险覆盖范围和 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，没有研究表明 在移民和季节性人群中量化极端高温和与高温相关的疾病之间的联系 美国的农场工人使用医疗记录并评估了潜在的脆弱性指标。我们的长期合作 目标是减少炎热对美国移民和季节性农场工人的健康影响。我们正在 独一无二地准备实现这一目标，因为我们可以利用第一个纵向医疗资源 年外来务工人员和季节性农场工人的记录数据库(基于社区的研究网络 具体来说，我们建议：1)确定所有原因和特定原因的超额案件 (与心血管、呼吸系统、糖尿病、肾脏和中暑有关的原因)疾病发生在流动人口和 热天纳入CBRN的季节性农场工人；以及2)评估脆弱性的潜在决定因素 通过评估是否与中暑发病有关，根据农场工人的状况，个人 特征和地理区域。这个项目解决了一个重要但很少被研究的极端高温- 这对弱势群体造成了相关的公共卫生问题，并对许多其他户外工作者产生了影响。 这项极具时间和成本效益的研究将是第一个调查与炎热有关的疾病的移民和 季节性农场工人使用美国的医疗记录。这项研究的结果可以帮助支持证据- 以政策制定为基础，制定和评估有针对性的干预措施，并改善对 工伤和职业病是农业部门非常需要的。这项工作与 《国家职业研究议程》确定的与农业部门有关的优先事项 中级目标5.4。这项研究通过以下方式为NIOSH研究实践(R2P)倡议做出了贡献 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.