Surveillance around hazardous waste sites: geographic information systems and reproductive outcomes.

The purpose of this paper is to discuss the potential for integrating surveillance techniques in reproductive epidemiology with geographic information system technology in order to identify populations at risk around hazardous waste sites. Environmental epidemiologic studies have had problems with estimating or measuring exposures to individuals, and of detecting effects when the exposure is low, but continuous. In addition, exposures around hazardous waste sites are complex and frequently involve chemical mixtures. The birth weight of human babies has been reported to be sensitive to many environmental influences. Birth weight can be analyzed as a continuous variable or as a dichotomous one using the standard cutpoint of 2500 g or less to indicate low birth weight. It has the potential to be a powerful surveillance tool since exposures to the fetus reflect maternal and paternal exposures. The advent of recent environmental regulations pertaining to hazardous waste sites has greatly increased the availability of environmental data for many sites. The major problem with incorporating these data into epidemiologic studies has been with the logistics of data management and analysis. Computer-assisted geographic information systems hold promise in providing capabilities needed to address the data management and analysis requirements for effective epidemiologic studies around to hazardous waste sites.     

Farm work practices and farm injuries in Colorado

STUDY OBJECTIVE:s: To describe the farm work patterns and the relationship between hours spent working on specific farm tasks and task specific work related injuries among women and men. DESIGN: A cross sectional survey of farm operators and their spouses in an eight county area of Colorado was conducted. Personal interviews were conducted between 1993 and 1997. Interviews took between 45 minutes to two hours to complete, depending on the complexity of individuals' personal histories. Farms were selected using stratified random sampling technique. SETTING: Eight counties in Northeastern Colorado representing 47% of agricultural production in the state. PARTICIPANTS: A total of 301 women and 459 men who were farm residents and involved in farm work were recruited. Outcome measure: Self reported injuries resulting in medical attention or treatment other than first aid, or inability to do normal work activities, or loss of consciousness, or transfer to another job were assessed in relationship to the specific job task being performed at the time of the injury. RESULTS: Women were at higher risk for injury than men when involved with other farm chores (rate ratio 8.18). For all other task related injuries, men and women were at similar risk when compared using hours of exposure to the farm tasks. CONCLUSION: Farm safety training and injury prevention programs need to include women working on farms.     

Early labor force exit subsequent to permanently impairing occupational injury or illness among workers 50‐64 years of age

Background

Severity of workplace injury tends to increase with age. Whether older workers who experience a workplace injury or illness exit the labor force sooner than comparable peers is not established.

Methods

A case‐cohort study design and complementary log‐log model were used to identify factors associated with average time to early substantial labor force exit among workers’ compensation claimants 50‐64 years of age with permanent impairment from an occupational injury or illness. Analysis was based on Ontario's workers’ compensation claimant data from 1998 to 2006 linked with Canadian tax files.

Results

Workers with permanent impairment left the labor force earlier, on average, than peers without claims. Early retirement was associated with older age in the injury/illness year, greater impairment, lower pre‐claim income, physically demanding jobs, and soft‐tissue injuries.

Conclusions

Policies aiming to extend older adults’ working lives should account for the potentially disparate impacts on older workers of occupational injury and illness.

     

The prevalence of depressive symptoms and risk factors among Iowa and Colorado farmers

BACKGROUND: Farmers have been previously reported to have higher rates of depression and suicide compared to other occupations. Comparisons of depressive symptoms and risk factors for states should increase understanding of depression in farmers. METHODS: Representative samples of 385 Iowa and 470 Colorado male principal farm operators in the respective state Farm Family Health and Hazard Surveillance projects were evaluated for depressive symptoms by using the CES-D scale. Risk factors were determined by using weighted multiple logistic regression analyses. RESULTS: Iowa farmers were 1.74 times (P < 0.05) more likely to have had depressive symptoms than Colorado farmers. Being unmarried (odds ratio=3.46), having negative life events within the past year [legal problems (4.67), substantial income decline (2.71), loss of something of sentimental value (3.20)], and lower perceived general health status were risk factors (P < 0.05) for depressive symptoms for male Iowa and Colorado farmers. Higher levels of most risk factors for Iowa farmers, almost twice the frequency of substantial income decline, accounted for the majority of the difference in depressive symptoms between Iowa (12.2%) and Colorado (7.4%). CONCLUSIONS: Although Iowa farmers had 1.74 times higher level of depression symptoms than Colorado farmers, this difference was not significant after adjusting for the higher levels of most risk factors for Iowa farmers.     

Pesticide poisoning and depressive symptoms among farm residents

PURPOSE: The purpose of the study presented is to evaluate the association between pesticides and depressive symptoms among a population exposed to chemicals as a result of agricultural use. Chronic sequelae of acute pesticide poisoning from organophosphate compounds may include anxiety and depression. In some states, farmers have been reported to have higher rates of depression than other population groups. Little work has been done to describe the effects of exposure to organophosphate compounds and depressive symptoms among the farming population. METHODS: Data for this study came from a cross sectional survey of farmers and their spouses conducted in an eight county area in northeastern Colorado. Personal interviews were conducted with the study participants. Depressive symptoms were assessed using the Center for Epidemiologic Studies-Depression (CES-D) scale. Pesticides applied on the farms were assessed using self-reported questionnaires. Conditional logistic regression was used to model the relationship between depression and pesticide-related illness in a stratified analysis. RESULTS: Between 1992-1997, 761 individuals were enrolled in this cross sectional survey. Adjusting for a number of potential confounders, the odds ratio for depression associated with pesticide-related illness was 5.87 [95% confidence interval (CI) = 2.56-13.44]. CONCLUSIONS: Exposure to pesticides at a high enough concentration to cause self reported poisoning symptoms was associated with high depressive symptoms independently of other known risk factors for depression among farm residents.     

Safety practices, neurological symptoms, and pesticide poisoning

Depression, anxiety, inability to concentrate, and spatial disorientation associated with pesticide poisoning may influence farmers' ability to comply with established safety procedures. The purpose of this article is to describe the relationship between safety practices, neurological symptoms, and pesticide poisoning. A survey of farm residents was conducted in an eight-county area in Colorado. Multivariate logistic regression models were used to determine associations between safety practices, neurological symptoms, and previous pesticide poisoning. A number of safety practices were associated with the following neurological symptoms: difficulty concentrating; feeling irritable; relatives noticing memory difficulties; and difficulty understanding reading materials. The associations between safety practices and neurological symptoms were increased in the presence of pesticide poisoning. Factors associated with failure to engage in established safety practices in this study were neurological symptoms.     

Nonoccupational and Occupational Injuries to US Workers With Disabilities

Objectives. We examined medically treated injuries among US workers with disability.Methods. Using 2006–2010 National Health Interview Survey data, we compared 3-month rates of nonoccupational and occupational injuries to workers with disability (n = 7729) and without disability (n = 175 947). We fitted multivariable logistic regression models to calculate odds ratios and 95% confidence intervals of injuries by disability status, controlling for sociodemographic variables. We also compared leading causes of injuries by disability status.Results. In the 3-month period prior to the survey, workers with disability were more likely than other workers to have nonoccupational injuries (odds ratio [OR] = 2.35; 95% confidence interval [CI] = 2.04, 2.71) and occupational injuries (OR = 2.39; 95% CI = 1.89, 3.01). For both groups, the leading cause was falls.Conclusions. Disability status was strongly associated with risk of nonoccupational and occupational injuries among US workers. The safety issues facing US workers with disability in the workplace warrant future research. Federal agencies with an interest in the employment of workers with disability and their safety in the workplace should take a lead in further assessing injury risk and in promoting a safe working environment for workers with disability.In the United States, persons with disabilities constitute 12.0% of the population.1 Both the World Health Organization and the US surgeon general have released reports addressing disparities in the health of persons with disabilities.2,3 These reports identify community participation and health promotion as societal priorities. According to the 2008 American Community Survey, about 4.6 million adults (aged 16–64 years) with disabilities are employed in the United States, and the number of workers with disabilities is expected to increase in the coming years as the workforce ages.4 A public health concern is that workers with disabilities may be at high risk of occupational injuries.5–8 Reducing the proportion of individuals with disabilities who report nonfatal injuries is among the objectives of US Healthy People 2020.9A number of studies have shown that adults with disabilities are more vulnerable to injuries than nondisabled adults.10–14 Studies using nationally representative data sets have found that the odds of injury increased with increasing severity of disability10,12 and with the number of disabilities.13 The settings and external causes of these injuries differed between individuals with and without disabilities.11,12 Falls, for example, were a leading mechanism of injury reported more frequently among those with disabilities.10–12Occupational injuries among workers with disabilities have also been previously studied.5,15–19 A number of studies from the 1990s showed an elevated risk of injury among workers with disabilities.5,15–17,19 However, much of the prior research examined only those with specific types of disabilities.15–19 For example, older workers with poor hearing and poor vision were shown to have an elevated risk for occupational injuries.17 By contrast, recent research based on workers’ compensation insurance claims found that workers with cognitive disabilities sustained fewer injuries and experienced fewer absences due to injury than workers without cognitive disabilities.18Previous work has also been critiqued because of the conceptualization and definition of disability5 and because environmental factors or work accommodations for workers with disability could not be taken into account.20,21 Zwerling et al. found that approximately 12% of workers with impairments reported receiving some type of workplace accommodation.22 Recent work by Leff et al. explored the role of environmental factors (e.g., societal attitudes, the natural environment, and policies) in the functioning and societal participation of people with disabilities.14 Environmental factors were found to be independently associated with injury regardless of disability status; however, disability status remained a risk factor for injury, although environmental factors attenuated the association. One current conceptualization of disability, the World Health Organization’s International Classification of Functioning, Disability and Health (ICF), emphasizes environmental factors and has been used in recent studies to evaluate injury risks of persons with disabilities.10,12,23 The ICF defines disability as physical impairments, activity limitations, and participation restrictions that affect one’s interaction with the physical and social environment.24 However, the impact of this refined definition on the number of injuries to workers with disabilities has yet to be determined.Given the significant number of US workers with disabilities and the advancements in disability and injury definitions,25 we compared medically attended nonoccupational and occupational injuries among workers with and without disabilities, using data from the 2006–2010 National Health Interview Survey (NHIS). Our current study improves on previous studies by our team and other researchers by examining both nonoccupational and occupational injuries to workers with disabilities using a single data source and a newer definition of disability based on the ICF.