SARS-CoV-2 infection and long COVID among California farmworkers.

PURPOSE: The purpose of this cross-sectional study was to determine the prevalence of long COVID and identify its clinical manifestations among farmworkers in California. METHODS: We collected data on sociodemographic characteristics, anthropometrics, clinical chemistries and anti-SARS-CoV-2 immunoglobulin G antibodies, self-reported SARS-CoV-2 infection history, and standardized health tests and scales from 297 farmworkers in California between February and July 2022. RESULTS: Most participants were born in Mexico or Central America, had less than a high school diploma, and were overweight or obese. The prevalence of long COVID (defined as self-reported SARS-CoV-2 infection with symptoms >28 days) among farmworkers with a suspected or test-confirmed infection was 61.8%. Participants with long COVID had higher mean [95% CI] body mass index (32.9 [31.6-34.1]) and high-sensitivity C-reactive protein levels (4.8 [3.7, 6.0]) than those with no COVID-19 history (30.5 [29.3-31.7], and 3.3 [2.2, 4.3], respectively). Farmworkers with long COVID also reported greater fatigue, dyspnea, taste and smell problems, and overall poorer mental and physical health, than those with no COVID-19 history. Farmworkers with long COVID had increased odds of functional limitations compared to those with a self-reported SARS-CoV-2 infection with symptoms ≤28 days (OR [95% CI]: 7.46 [3.26, 17.09]). CONCLUSIONS: A significant proportion of farmworkers experience long COVID with persistent symptoms that limit their ability to perform their work. A comprehensive approach that addresses the unique needs and challenges of farmworkers is warranted given this population's high prevalence of long COVID and the essential nature of their work.

Health Insurance Coverage for Farmworkers in California After the Introduction of the Affordable Care Act: A Mixed-methods Study.

BACKGROUND: Previous studies have found that health insurance coverage expanded for farmworkers from 2011-2012 to 2015-2016 due in part to the introduction of the Patient Protection and Affordable Care Act (ACA). This study examines the continued impact of the ACA on insurance coverage for farmworkers to 2018 and identifies barriers to further expansion. METHODS: A mixed-methods approach was utilized. Weighted statistical analyses were conducted on the National Agriculture Worker Survey (NAWS) data for 2011-2012, 2015-2016, and 2017-2018. Qualitative interviews conducted with agricultural employers, health care providers, and community-based organizations examined the impact of the ACA on health insurance coverage for farmworkers. RESULTS: Though health insurance coverage for farmworkers in California increased after the introduction of the ACA (from 37.3% in 2011-2012 to 56.5%% in 2015-2016), coverage rates grew only modestly between 2015-2016 and 2017-2018 (64.8%). Coverage rates were higher for documented (43.0% in 2011-2012 and 77.7% in 2017-2018) than for undocumented workers (26% in 2011-2012 and 46.8% in 2017-2018). The results from the qualitative interviews suggested that barriers to increased coverage include the high cost of insurance for growers, high deductibles and copays for farmworkers, and distrust of government agencies. CONCLUSIONS: While the period after the ACA was associated with notable improvements in health insurance coverage for farmworkers in California, important barriers remain for farmworkers seeking to obtain insurance and for growers seeking to provide coverage. POLICY IMPLICATIONS: States should consider funding a farmworker-specific Medicaid program to provide health insurance coverage and care coordination across counties and states.

Environmental impact of metal and metalloid leaching from highway marking glass beads.

Recently, metals and metalloids have been observed at elevated concentrations in glass beads imported to the US. Average total concentrations in imported batches ranged from 103 to 683 mg kg(-1) for As, 62 to 187 mg kg(-1) for Sb, and 23 to 179 mg kg(-1) for Pb. The labile fraction associated with the glass beads resulted in leached concentrations as great as 538 µg L(-1) for As, 1092 µg L(-1) for Pb, and 160 µg L(-1) for Sb. Sequential extraction was conducted as well to better understand the form of metals and metalloids associated with the glass beads. Only 0.23% of As, 3.40% of Pb, 2.37% of Ba, and 1.92% of Mn were extracted in the exchangeable (As, Mn, and Ba) and the oxidizable forms (Pb), whereas greater than 97% of metals and metalloids present were associated with the glass matrix. Nonparametric statistics were applied to test total concentrations that resulted in exceedances in the groundwater quality criteria. Results demonstrated that the As, Pb, and Sb limits were exceeded for 98%, 58%, and 15% of the samples tested respectively suggesting a potential environmental impact to groundwater used as a drinking water source.