Biomedical subjects

T A Arcury

Publications and source records attributed to T A Arcury.

At least 19 recordsLinked to original sources

PubMed2006

Skin disease among Latino farmworkers in North Carolina.

An estimated 4.2 million seasonal and migrant farmworkers and their dependents live in the U.S. Most of these farmworkers are Latino. These workers are exposed to numerous occupational and environmental risk factors that can result in skin disease. Few data exist on the prevalence of skin disease in this population. The purpose of this study was to estimate the prevalence and predictors of skin disease in a sample of Latino farmworkers in North Carolina. A sample of 59 farmworkers was recruited and interviewed at two camps during the 2004 agricultural season. A dermatologist completed a skin exam of each worker and recorded any skin disease present. Forty-two (77.7%) of the 54 men, and all five of the women examined had a diagnosed skin disease. For the men, onychomycosis (nail fungus, 31.5%), tinea pedis (foot fungus, 27.8%), and acne (24.1 %) were the most commonly diagnosed skin diseases, with contact dermatitis diagnosed in 5.6% of the sample. Other diagnoses included scars, sunburn, and atopic dermatitis. Among the women, diagnoses included melasma (dark patches on the face, 2 cases), xerosis (excessively dry skin, 1 case), tinea pedis (2 cases), onychomycosis (1 case), acne (1 case), and insect bites (1 case). There were no statistically significant differences between workers in the two camps despite different growing seasons and different crops harvested. Skin disease is prevalent among the North Carolina Latino farmworkers who participated in this study, with fungal disease being the most prevalent.

Acne Vulgaris↗

PubMed2003

Farmer health beliefs about an occupational illness that affects farmworkers: the case of green tobacco sickness.

Latino migrant and seasonal farmworkers, like all agricultural workers, experience high rates of occupational illness and injury. Interventions to reduce occupational injury among farmworkers must attend to the health beliefs of agricultural employers as well as employees, as employers control many aspects of the work environment. Occupational safety programs for Latino migrant and seasonal farmworkers must also be conceptually based in health behavior change and health disparities theories. We examine health beliefs of tobacco farmers about green tobacco sickness (GTS) to show the importance of delineating employer beliefs in agricultural safety. GTS is a highly prevalent occupational illness among tobacco workers that results from nicotine poisoning through dermal absorption of nicotine during cultivation and harvesting. We use qualitative methods structured by the Explanatory Models of Illness approach to identify farmer beliefs about the etiology, onset, pathophysiology, course, and treatment of GTS. Data were collected through semi-structured in-depth interviews with 15 North Carolina tobacco farmers. A computer-assisted, systematic qualitative analysis framework was applied to the interview transcripts. While tobacco farmers were generally knowledgeable about GTS, their explanatory models for this occupational illness often mis-identified its causes (heat and bending rather than nicotine) and minimized its seriousness. These models included methods of prevention that are not proven (e.g., use of anti-nausea drugs) or are more harmful than GTS (smoking cigarettes). The need for medical treatment was also discounted. Addressing each of these beliefs is important in any program to prevent GTS among farmworkers. Documenting and understanding the beliefs and knowledge of agricultural employers is an important undertaking in our efforts to reduce occupational injury and illness among farmworkers.

Adult↗

PubMed2003

An exploratory analysis of occupational skin disease among Latino migrant and seasonal farmworkers in North Carolina.

Occupational skin disease is highly prevalent among all agricultural workers. However, few data exist on risk factors for occupational skin disease among migrant and seasonal farmworkers. The goal of this analysis was to further document the prevalence of occupational skin disease among Latino farmworkers and delineate risk factors. This exploratory analysis used data collected in repeated survey interviews with Latino farmworkers in North Carolina in June and July (early season) and in August and September (late season), 1999. Respondents were largely male (95%) and from Mexico (95%), with about one-third each age 18-24, 25-34, and 35 and older. About half were in the U.S. on work contracts. Independent variables included the physical environment (crops worked), the social environment (having received pesticide safety training, having a work contract), and behavior and individual characteristics (re-wearing work clothes, showering after work, age). The dependent measures were reporting having had itching or burning skin or a skin rash in the two months prior to each interview; 24% of the respondents in the early season, and 37% in the late season reported skin disease signs and symptoms during the previous two months. Those reporting signs and symptoms in the early season were more likely to report them in late season. Significant independent risk factors for skin signs and symptoms in early season were re-wearing work clothes, showering after work, and being age 35 or older. In late season, those who had not received pesticide safety training had lower odds of reporting skin disease signs and symptoms, after adjusting for other potential risk factors. This exploratory study indicates that Latino migrant and seasonal farmworkers experience a high incidence of occupational skin disease. Further research is required with improved measurement of skin disease signs and symptoms, diagnosis of specific skin disease, and improved measurement of risk factors.

Adult↗

PubMed2001

Farmworker reports of pesticide safety and sanitation in the work environment.

BACKGROUND: Migrant and seasonal farmworkers are at risk for occupational illnesses from pesticide exposure, and the effectiveness of pesticide safety regulations has not been evaluated. It is important to learn from farmworker safety experiences to develop effective measures to improve agricultural workplace safety. METHODS: Formative research included in-depth interviews with farmworkers, farmers, extension agents, and health care providers. Survey research included interviews with 270 minority farmworkers during 1998, and 293 during 1999. RESULTS: Farmworkers and farmers hold different beliefs concerning pesticide safety which affect sanitation practices. Farmworkers report in survey data that farmers do not adhere to regulations mandating training and basic sanitation facilities. CONCLUSIONS: Several points of intervention are available to improve pesticide safety and sanitation. Additional regulation by itself is not an advantageous starting point. The emphasis for intervention must include educating farmers as well as farmworkers.

Agriculture↗

PubMed2001

Pesticide exposure beliefs among Latino farmworkers in North Carolina's Christmas tree industry.

BACKGROUND: Pesticide exposure is a major preventable occupational hazard for farmworkers. This study examined the beliefs of Latino farmworkers in North Carolina's Christmas tree industry regarding pesticide exposure. METHODS: In-depth interviews were conducted with 20 Mexican male seasonal farmworkers. Participants discussed beliefs about agricultural chemicals, routes of exposure, and health effects of these chemicals. They also discussed their knowledge and use of pesticide safety practices and safety training received. RESULTS: Most farmworkers knew that pesticides could be harmful, though workers varied in their levels of knowledge regarding routes of exposure, specific health effects of pesticides, and ways to avoid and reduce exposure. Workers varied considerably in the amount of safety training received and use of safety practices. Perceived lack of control and health beliefs were salient factors that decreased workers' use of safety practices. CONCLUSIONS: This study adds to the growing body of research which documents the health beliefs of Latino farmworkers in the U.S. relative to pesticides and pesticide safety. This literature is beginning to show convergence on several points (e.g., farmworker knowledge of acute vs. long-term illness resulting from pesticide exposure), as well as regional variation in pesticide safety beliefs. This study substantiates the need for pesticide safety education to address issues of control as well as beliefs.

Adult↗

PubMed2001

Developing socio-spatial knowledge networks: a qualitative methodology for chronic disease prevention.

Chronic disease is a significant and costly social problem. The burden is even more pronounced in communities with high rates of a particular chronic disease. Assessment of health belief systems and the local geographies of health beliefs can assist community health planners to create cost-effective strategic intervention programs where populations are at high risk for chronic diseases. In this paper, we elaborate the concept of socio-spatial knowledge networks (SSKNs) and demonstrate that SSKNs can be useful in informing the design of health care prevention strategies. In our project, we demonstrate how to identify key socio-spatial information for intervention strategies which will prevent or delay the onset of a particular chronic disease, Type 2 diabetes. Our qualitative framework allows us to determine which sites might be best characterized as socio-spatial knowledge network nodes for sharing diabetes information and which sites might be less suited to such exchange. Our strategy explores cross-cultural similarities, differences, and overlap in a multi-ethnic rural North Carolina context through simple techniques such as mapping social networks and sites in which people share their knowledge and beliefs about diabetes. This geographical analysis allows us to examine exactly where health knowledge coincides with other social support, and where such resources may be improved in a particular community. Knowing precisely what people in a community understand about a chronic disease and its treatment or prevention and knowing where people go to share that information helps to (1) identify strategic locations within a community for future interventions and, (2) evaluate the effectiveness of existing interventions. The geographical approach presented here is one that can serve other communities and health practitioners who hope to improve chronic disease management in diverse local environments.

Aged↗

PubMed2001

Staying healthy: the salience and meaning of health maintenance behaviors among rural older adults in North Carolina.

Beliefs about what constitutes health promoting behaviors vary by culture and class, and knowing how an older adult interprets a specific health behavior can improve health education and medical compliance. Ethnomedical approaches have investigated how people define disease and the therapies used to return to a state of health. However, little research has addressed how individuals define health, or the behaviors they use to maintain health. We analyze the behaviors elders state are needed to stay healthy, and their meanings for these behaviors. Narratives collected through in-depth interviews with 145 male and female rural North Carolina residents aged 70 and older, including African Americans, Native Americans and European Americans are analyzed using systematic text analysis. The participants' narratives include seven salient health maintenance domains: (1) Eating Right, (2) Drinking Water, (3) "Taking" Exercise, (4) Staying Busy, (5) Being with People, (6) Trusting in God and Participating in Church, and (7) Taking Care of Yourself. Several of these domains are multi-dimensional in the meanings the elders ascribe to them. There is also overlap in the content of some of the domains; they are not discrete in the minds of the elders and a specific health behavior can reflect more than one domain. Four themes cross-cut the domains: "balance and moderation", "the holistic view of health", "social integration", and "personal responsibility". Elders in these rural communities hold a definition of health that overlaps with, but is not synonymous with a biomedical model. These elders' concept of health seamlessly integrates physical, mental, spiritual, and social aspects of health, reflecting how health is embedded in the everyday experience of these elders. Staying healthy is maintaining the ability to function in a community. These results indicate that providers cannot assume that older patients will share their interpretation of general health promotion advice.

Black or African American↗

PubMed2001

Preventing occupational exposure to pesticides: using participatory research with latino farmworkers to develop an intervention.

Pesticide exposure is an occupational health hazard for migrant farmworkers. The US-EPA Worker Protection Standard (WPS) mandates training programs to prevent or reduce exposure. WPS implementation in a local context requires understanding individual, workplace, and community environmental factors that lead to exposure and influence intervention effectiveness. Participatory research within the PRECEDE-PROCEED planning framework was used to design a WPS training program for Mexican farmworkers in North Carolina cucumber and tobacco production. Research with farmworkers, farmers, health care providers, and Cooperative Extension agents identified modifiable behaviors and environmental factors, as well as structural and regulatory barriers requiring intervention. Data were gathered and analyzed through individual and group interviews, community forums, an advisory board, and a partnership between academic researchers and a community-based organization. The intervention's dominant features are (a) focus on key health behaviors, (b) relevance to local conditions, and (c) attention to issues of control in the workplace. Participatory research is effective for designing a health intervention where diverse social, cultural, political, and regulatory issues affect farmworkers' risk of exposure.

Journal Article↗

PubMed2001

The incidence of green tobacco sickness among Latino farmworkers.

We estimated the prevalence and incidence density (ID) and the risk factors of green tobacco sickness among minority farmworkers in North Carolina. Using a prospective surveillance design, 182 farmworkers were interviewed up to 5 times at biweekly intervals in 1999. The green tobacco sickness prevalence was 24.2%, whereas the ID was 1.88 days per 100 days worked. Greater work experience (5+ years, ID = 0.87; first year ID = 2.41) and tobacco use (ID of 1.18 vs 2.39) were negatively associated with green tobacco sickness. Task (e.g., priming ID, 4.04; topping ID, 1.86; barning ID, 0.62) and working in wet clothing (25% of workdays ID, 2.97; fewer than 25% of workdays ID, 1.29) had the largest effect. More effort must be directed toward preventing this occupational illness that affects workers who have little control over workplace safety.

Adolescent↗

PubMed2001

Environmental and behavioral predictors of salivary cotinine in Latino tobacco workers.

We report the results of a cohort study of 182 seasonal and migrant farmworkers engaged in tobacco production in two North Carolina counties. Data were collected on tobacco work tasks and risk factors for exposure to nicotine, including smoking, every 2 weeks over a 10-week period during the summer of 1999. Saliva samples were collected for cotinine analysis at every contact. Salivary cotinine levels increased across the season, independent of smoking status. Multivariate analyses identified a model (R2 = 0.68) in which predictors of cotinine included greater age, later-season work, wet working conditions, smoking, and work task. Harvesting ("priming") tobacco was associated with higher cotinine levels than other tasks. This study demonstrates that tobacco workers experience substantial work-related exposure to nicotine. The long-term effects of such exposure should be investigated.

Adult↗

PubMed2001

Predictors of incidence and prevalence of green tobacco sickness among Latino farmworkers in North Carolina, USA.

STUDY OBJECTIVE: The characteristics of some populations make epidemiological measurement extremely difficult. The objective of this study is to identify risk factors that explain variation among incidence densities and proportions of one occupational illness, green tobacco sickness, within one such special population, Latino migrant and seasonal farmworkers in the United States. DESIGN: Prospective cohort study. SETTING: 37 farmworker residential sites located in Granville and Wake Counties, North Carolina, USA. PARTICIPANTS: 182 migrant and seasonal farmworkers that included 178 Latino men, three Latino women, and one non-Hispanic white man. MAIN RESULTS: Green tobacco sickness had a prevalence of 0.082, and an incidence density of events per 100 days of 1.88 among the farmworkers. Prevalence and incidence density increased from early to late agricultural season. Major risk factors included lack of work experience, work activities, and working in wet clothes. Tobacco use was protective. CONCLUSION: Green tobacco sickness has a high incidence among migrant and seasonal farmworkers. Because workers have little control over most risk factors, further research is needed to identify ways to prevent this occupational illness.

Adolescent↗

PubMed2001

Farmworker pesticide exposure and community-based participatory research: rationale and practical applications.

The consequences of agricultural pesticide exposure continue to be major environmental health problems in rural communities. Community-based participatory research (CBPR) is an important approach to redressing health disparities resulting from environmental causes. In this article we introduce a collection of articles that describe projects using CBPR to address the health disparities resulting from pesticide exposure in agricultural communities, particularly the communities of migrant and seasonal farmworkers. The articles in this collection are based on a workshop convened at the 1999 American Public Health Association meeting. The goals in presenting this collection are to provide those endeavoring to initiate CBPR projects needed information, guidelines, and procedures to improve the quality of the CBPR experience; to increase the scientific validity of CBPR projects; and to reduce the potential difficulties and stress of these collaborations. In this introduction we discuss the context in which these projects operate, summarizing background information about farmworkers in the United States, what is known about farmworker pesticide exposure, and the concept of community-based participatory research. Finally, the articles in this collection are summarized, and major themes common to successful CBPR projects are identified. These common features are taking the time to interact with the community, using multiple approaches to engage the different parts of the community, understanding different participants often have different goals, appreciating each group's strengths, valuing community knowledge, and being flexible and creative in conducting research. The final article in this collection describes the translational research program at the National Institute of Environmental Health Sciences (NIEHS) highlighting activities pertinent to the health of rural communities, giving an overview of NIEHS-supported projects addressing health concerns of Native Americans and rural African-American communities in addition to farmworkers, and discussing future plans for CBPR at NIEHS.

Agriculture↗

PubMed2001

Something for everyone? A community and academic partnership to address farmworker pesticide exposure in North Carolina.

Partnerships between academic researchers and community organizations are frequently formed to address environmental health concerns in underserved communities. Although such participatory approaches to research combine valuable assets of both partners, they are often difficult to maintain. We describe a partnership formed to investigate migrant and seasonal farmworker exposure to pesticides in North Carolina and to develop effective interventions to reduce exposure. North Carolina ranks fifth in the United States in the number of farmworkers; most are from Mexico, and a significant minority come to the United States on work contracts. Several barriers to establishing effective collaboration were recognized in this partnership, including stereotypes, cultural differences, competing demands for time and attention, and differences in orientation to power structures. To overcome these barriers, members of the partnership took actions in three domains: clarifying the different goals of each partner, operationalizing a model of participation that could involve many different community segments developing cultural sensitivity. By taking these actions, the work of the partnership was accomplished in ways that met the criteria for success of both academic researchers and community members. This approach can be used by others to develop collaborative relationships to investigate environmental health issues within a community-based participatory framework.

Adolescent↗

PubMed2001

Training farmworkers about pesticide safety: issues of control.

Farmworkers experience a lack of control over the conditions of their work environment. In trying to reduce the effects of exposure to pesticides, most health care providers give instructions to farmworkers about how to protect themselves. Outreach programs that target farmworkers focus on health education and recommend washing hands, wearing appropriate clothing, and avoiding direct contact. The research reported in this paper shows that farmworkers in North Carolina perceive many of these preventive measures to be outside their control. The ability of farmworkers to engage in safe practices depends on their capability to communicate with their employer, have positive work relationships, and the availability of protective equipment. The perceptions of control identified in this paper are issues that service providers and policy makers should consider to provide programs that will effectively promote pesticide safety and healthier farmworkers.

Agricultural Workers' Diseases↗

PubMed2001

Eye symptoms and use of eye protection among seasonal and migrant farmworkers.

BACKGROUND: Farmworkers face an array of environmental and workplace hazards that pose risks of eye damage from accidents involving agricultural chemicals and equipment and from exposure to wind, dust, and ultraviolet rays. Eye safety risks are known among industrial and agricultural occupations, yet little is known about the prevalence of eye symptoms and use of eye protection among farmworkers. METHODS: A survey of 197 Latino farmworkers in North Carolina used self-report data to measure workers' prevalence of eye symptoms and eye protection use. RESULTS: Eye pain and redness after working all day in the field were reported by more than 40% of workers. Most (98.4%) reported not wearing sunglasses when working in the fields; reasons included lack of sunglasses and interference with field tasks. CONCLUSIONS: Eye symptoms are prevalent in this population. Failure to use eye protection indicates the need for further education and training of Latino farmworkers and their employers about occupational risks to eyesight.

Adult↗

PubMed2000

Migrant farmworkers and green tobacco sickness: new issues for an understudied disease.

BACKGROUND: The transition from family tobacco production to dependence on hired labor has placed migrant and seasonal farmworkers (MSF) at risk for green tobacco sickness (GTS). No previous studies of GTS have focused on MSF. METHODS: One hundred and forty-four Hispanic MSF working in tobacco production in North Carolina were surveyed to obtain self-reports of GTS, preventive behaviors, and treatments. RESULTS: Forty-one percent reported having GTS at least once during the summer. Most had taken no precautions to prevent GTS. Ninety-six percent of those with GTS had tried to treat it. Antinausea medications were the most common treatments. Only 9% sought medical treatment; 7% lost work time. CONCLUSIONS: The incidence of GTS obtained by interviewing MSF is much higher than that in other studies, which have relied on rates of medical treatment or farmers' reports for their workers. MSF constitute a population at risk for GTS who have little control over work conditions to prevent GTS or seek treatment.

Agricultural Workers' Diseases↗

PubMed2000

An introduction to three studies of rural elderly people: effects of religion and culture on health.

The paper introduces three empirical studies which relate the religious beliefs and practices or rural older adults from different ethnic groups to their health behaviors. It briefly describes the rationale for the studies and their main components, including their aims, study sites, study populations, methods used, and their principal findings. Then it discusses two primary themes which run through all the papers, namely rurality and cross-cultural comparisons. Finally, several secondary themes are discussed, including the importance of place, types of analysis, variable definition, causal relationships among variables, types of healing, locus of control, discourses about religion and health, and the religion and health connection.

Journal Article↗

PubMed2000

Faith and health self-management of rural older adults.

This analysis uses in-depth interview data collected from 145 African American, European American and Native American men and women aged 70 and older who reside in two rural North Carolina counties to understand the role of religious faith and prayer in the health self-management of these older adults. The analysis addresses three specific questions: how do these older adults use religion to help them manage their health; are there ethnic and gender differences in the use of religion; and are differences in health status related to differences in the use of religion? The integral role of religion in the lives of these older rural adults is an overarching theme present in the interview texts. Six major themes link religion and health self-management: (1) prayer and faith in health self-management, (2) reading the Bible, (3) church services, (4) mental and spiritual health, (5) stories of physical healing, and (6) ambivalence. Faith and religious activities provide an anchor in the lives of these older adults. There is little variation in the use of religion for health self-management by gender, ethnicity or health status. These results suggest that the strength of religion in rural culture may limit the effectiveness of general religiosity scales to discern the relationship of religion to health and health behavior in rural populations.

Journal Article↗