Factors Associated with Safe Use of Agricultural Pesticides in Minnesota

Abstract: How farmers protect themselves against pesticide exposure has important public health consequences. To obtain insights into pesticide self-protection, this study obtained data on chemically resistant glove and other protective equipment use as they relate to the type of farming practice, demographic characteristics of farmers and their farming operations, farmers' preventive health beliefs and behaviors, and factors related to their health care. Data were obtained by telephone interviews conducted in six rural Minnesota counties. Survey respondents totaled 1,327 (82% response rate), with 502 reporting pesticide use. Ninety-five percent of the latter respondents believed in the effectiveness of protective equipment and 88 percent believed that pesticide exposures are harmful. Fifty-six percent of the subjects wore chemically resistant gloves and 22 percent wore other protective clothing 75 percent of the time or more when using pesticides. Glove use and certification to use restricted pesticides was less frequent for women. The use of protective equipment in this group of Minnesota farmers was weakly related to being certified to apply restricted pesticides, believing in the effectiveness of protective clothing, believing that smoking causes serious health problems, using crop insecticides, and distance to a health care facility.     

Effects of a Prekindergarten Educational Intervention on Adult Health: 37-Year Follow-Up Results of a Randomized Controlled Trial

Objectives. We used 37 years of follow-up data from a randomized controlled trial to explore the linkage between an early educational intervention and adult health.Methods. We analyzed data from the High/Scope Perry Preschool Program (PPP), an early school-based intervention in which 123 children were randomized to a prekindergarten education group or a control group. In addition to exploring the effects of the program on health behavioral risk factors and health outcomes, we examined the extent to which educational attainment, income, family environment, and health insurance access mediated the relationship between randomization to PPP and behavioral and health outcomes.Results. The PPP led to improvements in educational attainment, health insurance, income, and family environment Improvements in these domains, in turn, lead to improvements in an array of behavioral risk factors and health (P = .01). However, despite these reductions in behavioral risk factors, participants did not exhibit any overall improvement in physical health outcomes by the age of 40 years.Conclusions. Early education reduces health behavioral risk factors by enhancing educational attainment, health insurance coverage, income, and family environments. Further follow-up will be needed to determine the long-term health effects of PPP.Prekindergarten programs provide a secure environment in which children are cognitively enriched, typically via a curriculum that enhances math and linguistic skills. The prekindergarten years (approximately 3 to 4 years of age) are thought to be a critical window for children''s intellectual and socioemotional development.^1–4 Prekindergarten programs may be especially important for children with parents with a limited amount of education, who may not be able to provide as rich a learning environment as that available to children whose parents are better educated.³Prekindergarten programs targeting children from low-income households have been shown to produce lifelong improvements in schooling, income, family stability, and job quality.^5–16 These intertwined improvements in social circumstances may in turn improve health through reductions in behavioral risk factors, enhanced job safety, better health insurance coverage, safer neighborhoods of residence, better access to healthy foods, and lower levels of psychological stress.^7,9,16–20Nonetheless, the long-term causal linkage between education and health and the pathways through which education affects health have not previously been established in a randomized controlled trial. We investigated whether the High/Scope Perry Preschool Program (PPP) randomized controlled trial improved adult health outcomes and health behavioral risk factors and explored how these outcomes were mediated.     

An Educational Intervention Program for Prevention of Occupational Illness in Agricultural Workers*

ABSTRACT: This study assessed attitudes, knowledge and behavior related to respiratory health among 198 swine confinement operators, half of whom were assigned to an educational intervention and half of whom served as controls. The project identified significant gaps in knowledge regarding the swine confinement environment and the hazards posed by working in such an environment. Attitudes toward improving the environment were generally favorable, though barriers such as cost and time existed for some confinement operators. An educational program, consisting of six booklets mailed out at two-week intervals and a group meeting, resulted in significant knowledge gains for the intervention group in areas related to respiratory health and confinement. For example, while fewer than half of the participants recognized on the pretest the recommended levels of potentially hazardous substances such as dust, carbon monoxide, ammonia and hydrogen sulfide, more than 85 percent recognized the recommended levels on the posttest. Evaluations of the units and the group meetings indicate that confinement operators have responded favorably to the project. Follow-up evaluation is underway to determine whether changes in knowledge have led to changes in behavior.     

A Worksite Obesity Intervention: Results From a Group-Randomized Trial

Objectives. We used a participatory process to develop an obesity intervention appropriate for elementary school personnel.Methods. A randomized controlled trial included 16 school worksites (8 intervention, 8 control). Intervention schools formed committees to develop and implement health promotion activities for employees. Anthropometric and self-report data were collected at baseline and postintervention (2 years later). The primary outcome measures were body mass index (BMI), waist–hip ratio, physical activity, and fruit and vegetable consumption.Results. After adjustment for age, ethnicity, and job classification, employees in intervention schools reduced their BMI by an average of 0.04 kg/m², and those in control schools increased their BMI by an average of 0.37 kg/m². Comparisons for waist–hip ratio, weekly physical activity minutes, and fruit and vegetable consumption were not significant.Conclusions. The participatory process appeared to be an effective means for stimulating change. The intervention may have slowed and perhaps reversed the tendency of adults to gain weight progressively with age.Obesity in the United States is a major cause of preventable disease. Among adults, 31% of men and 33% of women are considered obese (body mass index [BMI; weight in kilograms divided by height in meters squared] ≥ 30 kg/m²),¹ and prevalence of obesity is higher among ethnic minorities than among non-Hispanic Whites. Obesity is associated with life-threatening chronic disease² and was responsible for the largest increase among causes of death in the decade between 1990 and 2000.³ Health problems associated with obesity cost the health care system an estimated $75 billion per year,⁴ and indirect costs, such as loss of work time, further inflate this figure.In his Call to Action to Prevent and Decrease Overweight and Obesity, the surgeon general cited schools and worksites as environments that can promote the development of healthful behaviors.⁵ Almost 6 million adults work in public schools in the United States.⁶ The school environment is thought to be conducive to worksite health promotion because of access to facilities for physical activity and for educational purposes.⁷ Staff wellness is 1 of the 8 components of the Coordinated School Health Model, a conceptual model that addresses the school environment.^8,9 Health promotion in the school setting has the potential of reducing absenteeism, lowering turnover rates, and lowering insurance rates. In addition to these direct benefits, healthy teachers create an optimistic school climate, serve as role models to students, and reinforce positive health messages. These teachers are also more likely to incorporate health education into their lessons.¹⁰ Broadly, healthy employees influence the school community, including parents and students.⁷We used a participatory process to develop an intervention appropriate for elementary school personnel. The goal was to reduce obesity by promoting healthy dietary and exercise behaviors among personnel in a large, urban school district. Community-based participatory research is a cooperative process that engages community members and researchers as equals,¹¹ involving community members in designing and implementing interventions appropriate for their needs.¹² This approach has been shown to enhance effectiveness and save time and money.¹³ The participatory process may foster an enhanced sense of ownership, thereby increasing the likelihood that interventions will be institutionalized and sustained after startup resources have been exhausted.The overall theoretical umbrella for this research is social cognitive theory,¹⁴ emphasizing the person, the environment, and their interaction. Self-efficacy, or the individual''s belief that she or he can perform the behaviors to reach the desired goal, is a key personal construct that has been associated with behavior change. Perceived barriers to change, such as lack of access to healthful food or opportunities for exercise, are an important aspect of the environmental domain. Impressions of the social norms regarding behaviors are relevant to the interaction of the person and the environment. The participatory process of developing the intervention can enhance the extent to which school personnel share norms about the value of maintaining a healthy weight and the means to achieve it. The emphasis on social norms in behavior change is also compatible with the theories of reasoned action and planned behavior.^15,16 In any group intervention, but particularly one that incorporates a participatory process, the group environment becomes part of the intervention. Thus, an environment that builds camaraderie and fosters support can be a crucial element in the success of the intervention.In the analyses presented here, we tested 2 hypotheses: (1) individuals employed at school worksites randomly assigned to be intervention schools would be significantly more likely to lose weight (as evidenced by reduction in BMI and waist–hip ratio) than individuals employed at comparable control worksites; and (2) individuals in intervention schools would be significantly more likely to change diet and physical activity behaviors than individuals at control worksites. In sum, the hypotheses address the questions of whether the intervention worked and how it worked.     

Educational attainment and nutrient consumption patterns: the Minnesota Heart Survey

To explore whether dietary patterns differ according to educational attainment, we examined the associations of nutrient intake with educational level in a sample of 825 male and 893 female Twin Cities (Minneapolis and St. Paul) residents aged 25 to 74 years who were surveyed between 1980 and 1982. Of particular interest was the pattern of macronutrient consumption, since the proportion of fat and type of fat in the diet is thought to be related to the development of chronic disease. Estimates of nutrient intake were based on 24-hour dietary recalls, while information on education was obtained through interview. Educational attainment was positively associated with nutrient consumption patterns that may decrease risk of chronic disease for both men and women. For women, the proportion of dietary fat was less (p = .03) and carbohydrate greater (p = .004) with increasing education. For men, the Keys dietary score decreased as education increased (p = .05) (high scores indicate greater blood cholesterol-raising effect of the diet). Inverse associations of average total serum cholesterol level with education in both men (p = .02) and women (p = .06) support these dietary associations. These results suggest that educational attainment is related positively to eating patterns that may carry a decreased risk of cardiovascular and other chronic disease. Whether or not this association is causal, it would appear to point to a need for more effective nutrition education strategies for those with less education.     

The Minnesota Adolescent Community Cohort Study: Design and Baseline Results

The Minnesota Adolescent Community Cohort (MACC) Study is a population-based, longitudinal study that enrolled 3,636 youth from Minnesota and 605 youth from comparison states ages 12 to 16 years in 2000–2001. Participants have been surveyed by telephone semi-annually about their tobacco-related attitudes and behaviors. The goals of the study are to evaluate the effects of the Minnesota Youth Tobacco Prevention Initiative and its shutdown on youth smoking patterns, and to better define the patterns of development of tobacco use in adolescents. A multilevel sample was constructed representing individuals, local jurisdictions and the entire state, and data are collected to characterize each of these levels. This paper presents the details of the multilevel study design. We also provide baseline information about MACC participants including demographics and tobacco-related attitudes and behaviors. This paper describes variability in smoking prevalence and demographic characteristics for local units, and compares MACC participants to the state as a whole.     

Neuromuscular Function,in Agricultural Workers Using Pesticides

One hundred and two male agricultural workers who used pesticides underwent electromyographic (EMG) examination for signs of disturbed peripheral nerve and muscle function. In approximately 40%, abnormal EMG patterns were observed, similar to those found in myasthenic patients overtreated with neostigmine methylsulfate and pyridostigmine bromide and in male pesticide-factory workers exposed to mixed organophosphorus and organochlorine compounds. Fifty-three men were reexamined two months later and in 25 the EMG pattern changed either from abnormal to normal, or vice versa. Concurrent measurement of blood cholinesterase activity showed no difference between men with normal and abnormal EMG records; and all values were within normal limits, as were a number of biochemical blood measurements related to hepatic and renal function. No special causal agents were identified and no dosageresponse relationship was established.     

Agricultural Pesticides and Shingles Risk in a Prospective Cohort of Licensed Pesticide Applicators

Background: Some pesticides are immunotoxic and have been associated with an increased risk of immune-mediated diseases. The risk of shingles, the clinical reactivation of varicella-zoster virus, increases with aging and immunosuppression; little is known about its associations with pesticides.Objective: We examined the use of agricultural pesticides in relation to incident shingles in a prospective cohort of licensed pesticide applicators.Methods: The study sample included 12,820 (97% male) farmers (enrolled in 1993–1997 in North Carolina and Iowa), who were followed for a median of 12 y (interquartile range: 11–13). Shingles was self-reported at enrollment and at follow-up. We evaluated ever-use of 48 agricultural pesticides reported at study enrollment in relation to shingles risk and considered exposure–response for intensity-weighted lifetime days (IWLDs) of use. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazard models, adjusting for state, and allowing estimates to vary by median attained age (60 y).Results: Incident shingles was reported by 590 participants. Associations were positive (HRs>1.2) for ever- vs. never-use of eight insecticides, three fumigants, two fungicides, and five herbicides, and exposure–response trends were seen across increasing quartiles (Q3 and Q4>Q1) or tertiles (T3 and T2>T1) of IWLDs for four insecticides [permethrin (crops), coumaphos, malathion, and lindane], two fumigants (carbon tetrachloride/carbon disulfide and methyl bromide), and three herbicides [alachlor, trifluralin (<60 years of age) and 2,4-dichlorophenoxyacetic acid]. Shingles was not associated with total years or days per year mixed or applied any pesticides, but in older participants, shingles was associated with a history of a high pesticide exposure event [HR=1.89 (95% CI: 1.45, 2.45)].Conclusions: Several specific pesticides were associated with increased risk of shingles in farmers, especially at higher levels of cumulative use. These novel findings, if replicated in other populations, could have broader implications for the potential effects of pesticides on vaccine efficacy and susceptibility to other infections. https://doi.org/10.1289/EHP7797     

Educational Outcomes for Orphan Girls in Rural Zimbabwe: Effects of a School Support Intervention

Educational achievement has important implications for the health and well-being of young women in sub-Saharan Africa. The authors assessed the effects of providing school support on educational outcomes of orphan girls in rural Zimbabwe. Data were from a randomized controlled trial offering the intervention group comprehensive schooling support and controls no treatment initially and then fees only. Results indicated comprehensive support reduced school dropout and absence but did not improve test scores. Providing support to orphan girls is promising for addressing World Health Organization Millennium Development Goals, but further research is needed about contextual factors affecting girls’ school participation and learning.     

9种农药的急性毒性试验结果

目的检测40%杀扑磷乳油、100g/L联苯菊酯乳油、400g/L毒死蜱乳油、18g/L阿维菌素乳油、25g/L高效氯氟氰菊酯乳油、70%吡虫啉水分散粒剂、45%马拉硫磷乳油、3%多抗霉素湿性粉剂、200g/L吡虫啉可溶液剂9种农药的急性毒性。方法按照GB15670-1995《农药登记毒理学试验方法》对9种农药进行急性经口毒性试验、急性经皮毒性试验、家兔急性皮肤刺激试验、家兔眼刺激试验及豚鼠皮肤变态反应试验。结果 40%杀扑磷乳剂经口毒性为高毒级,100g/L联苯菊酯乳油为中毒级,其余7种为低毒级。急性经皮毒性9种均为低毒级。9种农药对皮肤刺激强度均为轻度刺激性。对眼的刺激强度均为轻度刺激性。9种农药皮肤变态反应试验均为Ⅰ级弱致敏物。结论 9种农药大多数为低毒农药,也有高毒和中毒农药,对皮肤和眼均有刺激性。生产者和使用者要注意个人防护。     

智能化呼吸机的安全使用及预防措施

本文介绍了智能化呼吸机近4年在临床应用55577天中存在1125次安全隐患的处理方法及预防措施。统计出近4年呼吸机的平均使用效率达67.83%,并介绍了呼吸机使用前的＂九步法＂检查法,经临床验证,可有效降低故障率,有较高的临床推广应用价值。     

Testing to Prevent Colon Cancer: Results From a Rural Community Intervention

PURPOSE

Colon cancer is the second leading cause of cancer death in the United States. Despite tests that can detect and enable removal of precancerous polyps, effectively preventing this disease, screening for colon cancer lags behind other cancer screening. The purpose of this study was to develop and test a community-based participatory approach to increase colon cancer screening.

METHODS

Using a community-based participatory research approach, the High Plains Research Network and their Community Advisory Council developed a multicomponent intervention—Testing to Prevent Colon Cancer—to increase colon cancer screening. A controlled trial compared 9 intervention counties in northeast Colorado with 7 control counties in southeast Colorado. We performed a baseline and postintervention random digit–dial telephone survey and conducted both intent-to-treat and on-treatment analyses.

RESULTS

In all, 1,050 community members completed a preintervention questionnaire and 1,048 completed a postintervention questionnaire. During the study period, there was a 5% absolute increase in the proportion of respondents who reported ever having had any test in the intervention region (from 76% to 81%) compared with no increase in the control region (77% at both time points) (P = .22). No significant differences between these groups were found in terms of being up to date generally or on specific tests. The extent of exposure to intervention materials was associated with a significant and cumulative increase in screening.

CONCLUSIONS

This community-based multicomponent intervention engaged hundreds of community members in wide dissemination aimed at increasing colorectal cancer screening. Although we did not find any statistically significant differences, the findings are consistent with an intervention-related increase in screening and provide preliminary evidence on the effectiveness of such interventions to improve colon cancer screening.     

Results of a Rural School-Based Peer-Led Intervention for Youth: Goals for Health

BACKGROUND: School-based interventions are critical for enhancing the health of youth. The Goals for Health (GFH) school-based project was a goal-setting and life-skills intervention conducted in rural areas to increase self-efficacy, knowledge, and positive behaviors related to healthy eating. The intervention was peer-led with high school students teaching health and life skills to sixth-grade students. The purpose of this study was to examine the impact of the GFH school-based program on healthy eating outcomes related to self-efficacy, attitudes, knowledge, and behavior, and to examine the impact of quality of program implementation on the above outcomes. METHODS: Twenty-three rural schools in Virginia (15) and New York (8) participated in the study. Twelve of the schools were intervention schools that received the 12-week GFH program. The remaining 11 were wait-list control schools. Sixth graders (n = 2120 baseline) from all schools were surveyed at 4 time points (preintervention, postintervention, 1 and 2 year follow-up). RESULTS: Results included significant change patterns across the 4 assessment points in the predicted direction for healthy eating-related self-efficacy and fat and fiber knowledge. No significant change patterns were found at follow-up for fat, fiber, or fruit and vegetable intake. Results also indicated differences across gender and ethnicity and significant findings related to quality of implementation. CONCLUSIONS: Future interventions need to provide opportunities to practice healthy living skills over an extended period of time, include components that focus on contextual change in the school and the family, and monitor program implementation.     

Results of a Multibehavioral Health-Promoting School Pilot Intervention in a Dutch Secondary School

PurposeRecent studies increasingly show adolescent health-related behaviors to be interrelated, interacting synergistically and sharing several common determinants. Therefore, research increasingly focuses on studying interventions that target a range of health behaviors simultaneously. This report describes the results of a pilot study of a secondary school–based, health-promoting intervention that simultaneously targets a range of adolescent health behaviors via a whole-school approach.MethodsWe collected self-reported behavioral data via an annual online questionnaire to 336 students. We collected data before the intervention implementation and after the intervention’s first completed, 3-year curriculum cycle on the fourth-grade students (15- to 16-year-olds). We analyzed differences between pre- and postintervention groups.ResultsSignificant behavioral changes were reported for extreme alcohol use, smoking, sedentary time, and bullying behaviors. Certain behaviors were significantly different only in girls: namely, weekly alcohol use, ever having used cannabis, compulsive Internet or computer use score, compulsive gaming score, and recent bully victimization. Differences in several sedentary time behaviors (television watching and Internet or computer use) were significant only in boys. No changes were reported regarding body mass index; physical activity; or the time spent on, or the compulsiveness of, video game playing. In addition, the postintervention group showed significantly fewer psychosocial problems.ConclusionsThe intervention successfully changed student health behaviors on many accounts. It remains largely unclear as to what causes the different effects for boys and girls. Further studies regarding multiple health behavior targeting interventions for adolescents are required.