Evaluation of Mexican American migrant farmworker work practices and organochlorine pesticide metabolites.

BACKGROUND: Epidemiologic studies often must rely upon questionnaire data to assess past exposures. The ability of questionnaires to rank migrant farmworkers according to past pesticide exposure is not known. METHODS: We conducted a pilot feasibility study to measure a panel of 21 organochlorine pesticides (OCPs) and correlate levels with reported occupational exposures in 26 Mexican-American migrant farmworkers in Baytown, Texas. The Migrant Farmworker Questionnaire developed by the National Cancer Institute (NCI) was administered and each participant donated a blood sample. Three OCPs [mean (ppb) levels: mirex 1.8, DDT 1.0, and trans-nonachlor 0.7] were detected despite the fact that these chemicals have been banned in the US for many years, and the detected levels were far higher than the standard provided by the referent laboratory. Work clothes, protective attire, and self-reported pesticide exposures were significant predictors of OCP exposure. Similarly, personal hygiene, length of employment, and number of duties also predicted OCP exposure. CONCLUSIONS: The results of this study indicate that data obtained from standardized questionnaires may be reasonable indicators of occupational exposure when biomarker data are not available.     

Determining the probability of pesticide exposures among migrant farmworkers: results from a feasibility study.

BACKGROUND: Migrant and seasonal farmworkers are exposed to pesticides through their work with crops and livestock. Because workers are usually unaware of the pesticides applied, specific pesticide exposures cannot be determined by interviews. We conducted a study to determine the feasibility of identifying probable pesticide exposures based on work histories. METHODS: The study included 162 farm workers in seven states. Interviewers obtained a lifetime work history including the crops, tasks, months, and locations worked. We investigated the availability of survey data on pesticide use for crops and livestock in the seven pilot states. Probabilities of use for pesticide types (herbicides, insecticides, fungicides, etc.) and specific chemicals were calculated from the available data for two farm workers. The work histories were chosen to illustrate how the quality of the pesticide use information varied across crops, states, and years. RESULTS: For most vegetable and fruit crops there were regional pesticide use data in the late 1970s, no data in the 1980s, and state-specific data every other year in the 1990s. Annual use surveys for cotton and potatoes began in the late 1980s. For a few crops, including asparagus, broccoli, lettuce, strawberries, plums, and Christmas trees, there were no federal data or data from the seven states before the 1990s. CONCLUSIONS: We conclude that identifying probable pesticide exposures is feasible in some locations. However, the lack of pesticide use data before the 1990s for many crops will limit the quality of historic exposure assessment for most workers.     

Acute hazards to young children from residential pesticide exposures

OBJECTIVES: This study assessed acute hazards to young children from pesticides toxic enough to require child-resistant packaging. METHODS: The names of pesticides meeting acute toxicity criteria were ascertained from the Environmental Protection Agency. Poison Control Center reports identified children younger than 6 years who were exposed to these pesticides. Toxicity category, medical outcome, sex, and age were examined. RESULTS: A higher proportion of children with exposure to the more toxic products had serious medical outcomes. Children 2 years and younger were the predominant age group exposed. CONCLUSIONS: Protective measures--substituting less lethal pesticides, reducing the concentration of the active ingredients, and improving packaging and storage--are recommended.     

Testing an intimate partner violence assessment icon form with battered migrant and seasonal farmworker women

A user-friendly assessment form using icons was developed for the Lideres Campesinas de California, Inc., a women farmworker organization in California, for assessing migrant and seasonal farmworker women for abuse. The purpose of this study was to test the reliability and validity of the form. Twenty-five women from the Lideres participated. The form, called the Intimate Partner Violence (IPV) Assessment Icon Form, was designed to be used with literate, semi-literate, and illiterate women. Inter-rater reliability and criterion-related validity of the IPV Assessment Form were found to be adequate for the literate and semi-literate participants. There were not enough illiterate women (n = 2) to include in the analysis. This study also demonstrates that with adequate training, support, and tools, migrant and seasonal farmworker women can work in partnership with researchers to design, develop and conduct research in their own communities.     

Work characteristics and pesticide exposures among migrant agricultural families: a community-based research approach

There are few data on pesticide exposures of migrant Latino farmworker children, and access to this vulnerable population is often difficult. In this paper we describe a community-based approach to implement culturally appropriate research methods with a migrant Latino farmworker community in Oregon. Assessments were conducted in 96 farmworker homes and 24 grower homes in two agricultural communities in Oregon. Measurements included surveys of pesticide use and work protection practices and analyses of home-dust samples for pesticide residues of major organophosphates used in area crops. Results indicate that migrant farmworker housing is diverse, and the amounts and types of pesticide residues found in homes differ. Azinphos-methyl (AZM) was the pesticide residue found most often in both farmworker and grower homes. The median level of AZM in farmworker homes was 1.45 ppm compared to 1.64 ppm in the entry area of grower homes. The median level of AZM in the play areas of grower homes was 0.71 ppm. The levels of AZM in migrant farmworker homes were most associated with the distance from fields and the number of agricultural workers in the home. Although the levels of AZM in growers and farmworker homes were comparable in certain areas, potential for disproportionate exposures occur in areas of the homes where children are most likely to play. The relationship between home resident density, levels of pesticide residues, and play behaviors of children merit further attention.     

A model program for providing health services for migrant farmworker mothers and children

A bilingual, multidisciplinary team of health professionals collaborated with a migrant health center in North Carolina to develop a model program to deliver primary health care services to migrant farmworker women and children. The program included case finding and outreach, coordination of maternal and child health services locally as well as interstate, and innovative health education programming. Data were collected on the health status of 359 pregnant migrant farmworker women and 560 children, ages birth to 5 years, the majority of Mexican descent, who received primary care services at the center. The mean age of the women was 23.1 years and their mean gravidity was 2.9. Dietary assessments showed that the protein intakes of most met or exceeded the U.S. Recommended Dietary Allowances, but their consumption of foods in the milk-dairy group and the fruit-vegetable group was below recommended standards. Low hematocrit was a common problem among the women (43 percent) and, to a lesser extent, among the children (26 percent). Among the infants and children, 18 percent were obese. Black American women had the highest proportion of low birth weight infants. The project emphasized coordinated services for migrant farmworker mothers and children, such as transportation services, language translation, followup, and advocacy. An outreach strategy involved case finding, home visits, and services by lay health advisors. By the third year of the project, there were increases in the average number of prenatal visits, the proportion of women entering prenatal care in their first trimester, and in the use of well-child services. The project demonstrated effective methods for delivering culturally appropriate health care services to migrant farmworkermothers and children using bilingual public health professionals.     

Women's douching practices and related attitudes: findings from four focus groups

PURPOSE: Vaginal douching is a common hygiene practice for many U.S. women, but is associated with several health risks. Little is known about the beliefs and attitudes that promote and maintain douching practices. This qualitative study, consisting of four focus groups of 31 southern women, was conducted to gather in-depth information about attitudes and beliefs associated with douching. The focus groups consisted of separate groups of low-income and middle-income Caucasian and African-American women. RESULTS: The African-Americans and low-income Caucasians were more likely to douche than middle-income Caucasians. The participants reported douching after menstruation, after sexual intercourse, and at other times for cleanliness and odor control. Concern about odor and cleanliness was a recurrent theme, and douching was represented as an expected and necessary part of feminine hygiene. Several socioeconomic and racial differences were observed in douching practices and attitudes. CONCLUSIONS: This study provides preliminary information about women's douching practices and attitudes that may inform practitioners' educational efforts and future research.     

A comparative study of pesticide exposures in adults and youth migrant field workers

To study possible differences between pesticide exposures received by youth (subjects less than 16 yr of age) and adults (subjects greater than 16 yr of age), human exposure samples (gloves and urine) were collected during the onion harvesting season of 1982. Environmental samples (soil, foliage, and field air) were also collected during the study period. All samples were analyzed for toxaphene, ethyl parathion, methyl parathion, and malathion. Environmental samples were found to have very low levels of these insecticides. The youth cohort had lower residue values than did the adults, and these differences were statistically significant (P less than 05) for toxaphene residues on gloves on each sampling day, and for ethyl parathion residues on gloves on one sampling day only. Detectable levels of dialkyl phosphates were found in only 2 of 44 urine samples.     

Modeling the dietary pesticide exposures of young children

A stepped approach was used to assess the exposures of 1 1/2-4 1/2-year-old children in the United Kingdom to residues of pesticides (dithiocarbamates; phosmet; carbendazim) found in apples and pears. The theoretical possibility that the acute reference dose (ARD) was being exceeded for a particular pesticide/fruit was tested by applying a combination of maximal variability and maximum measured residue relative to an average-body-weight consumer. The actual risk was then quantified by stochastically modeling consumption, from dietary survey data, with individual body weights, against published residue results for 2000-2002 and the variability of residue distribution within batches. The results, expressed as numbers of children per day likely to ingest more than the ARD, were in the range of 10-226.6 children per day, depending upon the pesticide and year of sampling. The implications for regulatory action are discussed.     

The dynamic process of focus groups with migrant farmworkers: the Oregon experience

Focus groups with culturally diverse populations, and Latino farmworkers in particular, have been used as an effective research method. However, the specifics of planning and implementing focus groups with diverse populations have not been elaborated in the literature. Focus groups were used as part of The Reducing Pesticide Exposure in Minority Families Project to sucessfully elicit migrant farmworkers' views on pesticide exposure and preferences for educational method. Although attention was paid to cultural and lifestyle considerations in the planning and implementation of our focus groups, recruitment, environmental context, convener, focus group questions, and within-population differences were identified as areas that required ongoing assessment and operational change. Vigilance to the dynamics of the process resulted in more effective focus groups.     

Organophosphorus pesticide urinary metabolite levels of children in farmworker households in eastern North Carolina

BACKGROUND: Organophosphorus (OP) pesticide urinary metabolite levels in a sample of farmworker children in North Carolina are documented and compared to national reference data. The relative importance of para-occupational, residential, and environment risk factors are delineated. METHODS: Urine samples were collected from 60 farmworker children 1-6 years of age, and interviews were completed by their mothers. Urine samples were analyzed for the dialkylphosphate (DAP) metabolites of OP pesticides. Summed molar concentrations of the diethyl and dimethyl DAP metabolites provided summary measures. RESULTS: The farmworker children had relatively high levels of OP pesticide urinary metabolites compared to national reference data; for example, participating children had higher geometric means for diethylphosphate (DEP), diethylthiophosphate (DETP), and the summed diethyl metabolites. However, analyses found no pattern of significant associations between predictors and metabolite levels. CONCLUSIONS: Future research requires greater precision in sampling and measurement to determine the risk factors for pesticide exposure among farmworker children.     

Relative pesticide and exposure route contribution to aggregate and cumulative dose in young farmworker children

The Child-Specific Aggregate Cumulative Human Exposure and Dose (CACHED) framework integrates micro-level activity time series with mechanistic exposure equations, environmental concentration distributions, and physiologically-based pharmacokinetic components to estimate exposure for multiple routes and chemicals. CACHED was utilized to quantify cumulative and aggregate exposure and dose estimates for a population of young farmworker children and to evaluate the model for chlorpyrifos and diazinon. Micro-activities of farmworker children collected concurrently with residential measurements of pesticides were used in the CACHED framework to simulate 115,000 exposure scenarios and quantify cumulative and aggregate exposure and dose estimates. Modeled metabolite urine concentrations were not statistically different than concentrations measured in the urine of children, indicating that CACHED can provide realistic biomarker estimates. Analysis of the relative contribution of exposure route and pesticide indicates that in general, chlorpyrifos non-dietary ingestion exposure accounts for the largest dose, confirming the importance of the micro-activity approach. The risk metrics computed from the 115,000 simulations, indicate that greater than 95% of these scenarios might pose a risk to children's health from aggregate chlorpyrifos exposure. The variability observed in the route and pesticide contributions to urine biomarker levels demonstrate the importance of accounting for aggregate and cumulative exposure in establishing pesticide residue tolerances in food.     

Age-appropriate HIV prevention messages for older adults: findings from focus groups in New York State.

The Emerging Issues Committee of the New York State HIV Prevention Planning Group identified that prevention messages were not including persons 50 and older and that 15 percent of the newly reported AIDS cases in 1997 in New York were in this age group. Recognizing that there may be unique needs in targeting prevention messages for this age group, a consultant conducted five focus groups throughout the state to speak with people to determine what they identified as unique themes related to HIV prevention for this age group.     

A student community dental experience with migrant farmworker families and the rural poor.

For the past six years, 78 dental students have worked with 25 rural dentists to provide over 31,000 dental health services to migrant patients for all of Colorado's agricultural communities. In 1977, each of 19 dental students averaged over $538 per week in value of comprehensive dental services, including preventive and peridontal services (36 per cent, N=3,006); restorative services (46 per cent, N = 3,904); surgical services (8 per cent, N = 705); services in pulp therapy (5 per cent, N = 413); and an additional 5 per cent (N = 412) in miscellaneous services. A unique combination of federal resources from the Departments of Labor, and of Health, Education and Welfare, were combined through the Colorado State Health Department and the University of Colorado Medical Censtrated by: 1) a relatively low extraction to restoration ratio (1 to 5) when compared to reported studies (1 to 2); 2) a relatively low extract to root canal therapy (10 to 1) when compared to reported studies (400 to 1); 3) no statistical difference between students and rural practitioners in the quality of services as determined by peer review study. This dental program is an integrated component of a comprehensive program combining student and professional services in medicine, nursing, nutrition, and health education.     

The power of the collective: battered migrant farmworker women creating safe spaces

In this article I describe the use of a participatory action research (PAR) methodology to address the problem of domestic violence among migrant farmworker (MFW) women in California. The article was generated from a variety of data sources used by the investigator over a 4-year period. These include the investigator's observations, field notes, informal conversations, written stories from the women, and interviews. The "power of the collective" is discussed as the development of a power base for battered MFW women to support and take care of one another. The concepts of liberation, enlightenment, and "conscientizacion" are used to describe the evolution of the collective.