Heat-related illness and farmworker’s health: Climate change and precarious employment

摘要 密歇根州生命阶段环境暴露和疾病（M-LEEaD）核心中心（P30），由 国家环境健康科学研究所（NIEHS），总部设在密歇根大学， 围绕着对环境暴露敏感性的关键窗口这一主题， 疾病的决定因素。它的使命是加速界定环境暴露影响的研究 在生命的脆弱阶段，并将这些发现转化为改善医疗和公共卫生 干预措施。这种对M-LEEaD的多样性补充的目标是进行流行病学研究 研究热相关疾病（HRI）对农场工人健康的影响。极端高温事件是 在美国（US）的频率，强度和持续时间增加。15年分析 （1992-2006年）显示，农业作物工人与高温有关的平均年死亡率为0.39%， 10万工人，而美国平民人口为0.02。随着气候变化导致气温 如果气温继续上升，预计未来几十年热浪将变得更加频繁和严重。这是 美国农场工人的公共健康问题-主要是在不稳定的工作环境下工作的拉丁美洲人 条件和广泛的慢性疾病的影响，社会和经济因素， 加剧了他们对高温相关疾病的脆弱性。农场工人就业不稳定， 造成的不公平分布的环境污染是健康的一个关键社会决定因素， 对环境正义的影响。我们的具体目标是：（1）检查横截面协会的 基于就业的HRI和心血管疾病的风险因素，使用密歇根州的定性数据 农场工人项目，并进行系统的文献综述，以确定就业为基础的风险因素， HRI与健康然后，将使用全国农业工人协会的数据进行定量分析。 调查（NAWS 1999-2018），以评估其与心血管风险因素自我报告数据的相关性 （2）评估全国范围内因高血压和糖尿病死亡率的趋势分析， 农业工人的HRI（1992 - 2020年），使用劳工统计局的致命职业普查数据 伤害（CFOI）和CFOI中确定为暴露的热相关死亡数据，并计算死亡率 在全国范围内的农场工人。利用国家和公开的气象数据，我们将评估 热浪与同期农业工人死亡率的相关性，（3）发展 根据目标1和目标2的调查结果，使用英文“政策简报”，向农场工人散发材料 通过社交媒体平台提供环境科学信息， 在拟议研究结果的背景下，卫生和司法。拟议补编与 与M-LEEaD中心的使命，中心目标是进一步科学知识， 农业工人就业不稳定对环境和职业健康的影响。

ABSTRACT The Michigan Lifestage Environmental Exposures and Disease (M-LEEaD) Core Center (P30), funded by the National Institute of Environmental Health Sciences (NIEHS), is based at the University of Michigan and is organized around the theme of critical windows of susceptibility to environmental exposures as important determinants of disease. Its mission is to accelerate research that defines impacts of environmental exposures during vulnerable stages of life, and to translate those findings to improve medical and public health interventions. The goal of this diversity supplement to M-LEEaD is to conduct epidemiological research to study the impact of heat related illness (HRI) on the health of farmworkers. Extreme heat events are increasing in the United States (US) in frequency, intensity, and duration. Analysis from a 15 year period (1992-2006) showed that the heat-related average annual death rate for agricultural crop workers was 0.39 per 100,000 workers, compared with 0.02 for the US civilian population. As climate change causes temperatures to continue to rise, heat waves are expected to become more frequent and severe in the coming decades. This is a public health concern for US farmworkers—primarily Latinos(as) working under precarious working conditions and impacted by a wide range of chronic diseases, social and economic factors that may exacerbate their vulnerability to heat-related illnesses. Precarious employment for farmworkers--and the resulting inequitably distributed environmental exposures—is a key social determinant of health with implications for environmental justice. Our specific aims are: (1) To examine cross-sectional associations of employment-based risk factors for HRI and cardiovascular disease using qualitative data from the Michigan Farmworker project and conducting a systematic literature review to identify employment-based risk factors for HRI and health. Then, quantitative analysis will be conducted using data from the National Agricultural Worker Survey (NAWS 1999-2018) to assess its association with self-reported data on cardiovascular risk factors (hypertension and diabetes) collected in NAWS, (2) To assess nationwide trend analysis in fatality rates due to HRI in farmworkers (1992 – 2020) using data from the Bureau of Labor Statistics Census of Fatal Occupational Injuries (CFOI) and data on heat-related deaths identified in the CFOI as an exposure and calculate fatality rates among farmworkers nationwide. Using national and publicly available meteorological data, we will assess the correlation of heat waves with fatalities in farmworkers during the same time-period, (3) To develop dissemination materials for farmworkers based on findings in Aim 1 and 2 by using “policy briefs” in English and Spanish through a social media platform that provides accessible scientific information in environmental health and justice in the context of the findings of the proposed study. The proposed supplement is aligned with the mission of the M-LEEaD center with the central goal to further scientific knowledge on the environmental and occupational health impact of precarious employment in farmworkers.