Sexual Harassment Beliefs and Myth Acceptance Among Hispanic and Indigenous Farmworkers in California (USA) and Michoacán (Mexico).

We explore workplace sexual harassment (WSH) myth acceptance, bystander discomfort, and beliefs among farmworkers in California, USA, and Michoacán, Mexico. Surveys were conducted with the guidance of community advisory boards among 197 farmworkers (38 men and 59 women in California; 40 men and 60 women in Michoacán). Men and women in Michoacán had similar discomfort and myth acceptance. California women reported more discomfort than men but were similar in myth acceptance. The highest levels of myth acceptance ranged from 66 to 88%. The majority (85-90%) believed that something must be done to prevent WSH in agriculture.

Lessons From the Field: Rapid Antigen Testing Is Efficient and Practical for Mitigation of Coronavirus Disease 2019 Outbreaks in Long-Term Care Facilities.

Background: Mitigation of coronavirus disease 2019 (COVID-19) outbreaks in long-term care facilities (LTCFs) is facilitated by rapid identification and isolation of infectious individuals to interrupt viral transmission. Immunochromatographic (IC) tests, or rapid antigen tests, have high sensitivity and specificity during the contagious period for COVID-19. Mathematical modeling predicts frequent IC surveillance will be more efficient than polymerase chain reaction (PCR)-based strategies, especially during community surges when reporting of PCR results can be delayed. However, there are few published field studies evaluating IC testing strategies in this long-term care setting. Methods: In fall and winter of 2020, the Marin Health and Human Services Department implemented thrice-weekly IC mass testing by nonlaboratory workers in outbreaks that occurred in 2 LTCFs, in addition to then-standard semiweekly PCR testing. The IC test performance was characterized using same-day PCR specimens as reference standard. Cumulative incidence and duration of transmission for the 2 IC intervention facility outbreaks were compared with 6 reference LTCFs that used weekly to semiweekly PCR alone during an outbreak response. Results: Of 123 same-day test pairs, IC test sensitivity and specificity were 75% (95% confidence interval [CI], 48%-93%) and 100% (95% CI, 97%-100%), respectively. The median duration of outbreak transmission was 19.5 days in the 2 intervention sites and 28 days in the reference facilities (P = .40). Cumulative incidence for the outbreaks among LTCF residents was 41% in the intervention facilities versus 52% in the reference facilities (P = .04, Fisher 2-sided exact). Conclusions: Thrice-weekly mass IC testing as used by nonlaboratory personnel can be highly practical and effective for COVID-19 outbreak mitigation in the LTCF setting.

Exposure to Workplace Sexual Harassment among Women and Men Farmworkers in the U.S. and Mexico.

HIGHLIGHTS: Women and men farmworkers reported workplace sexual harassment (WSH). WSH occurred as frequently as daily. Both coworkers and leadership were perpetrators of WSH. ABSTRACT: This study explores experiences relevant to workplace sexual harassment (WSH) in agriculture among men and women farmworkers in California (U.S.) and Michoacán (Mexico). Anecdotal evidence documents women farmworkers having to endure behavioral, verbal, and physical WSH including sexual ogling, degrading language, groping, and requests for sex in exchange for work. We include survey comparisons between men and women in California and Michoacan on WSH among farmworkers. We conducted 197 farmworker surveys (38 men and 59 women in California; 40 men and 60 women in Michoacán). Community advisory boards contributed expertise and input for study strategies, materials, and dissemination. Survey participant ages ranged from 23 to 54 years old. Half worked in Mexico, 68% were married, 80% had children, and 47% had less than 7 years of education. Most farmworkers spoke Spanish and Purhépecha, an indigenous language spoken by the Purhépecha people in Michoacán. We used two strategies to measure WSH exposure in the previous year: (1) direct inquiry-based survey items (asking "Have you ever been the victim of or bystander to workplace sexual harassment?") documenting WSH among women (49%) and men (21%) in California and among women (7%) and men (13%) in Michoacán, and (2) behavior-based WSH items (using explicit examples of WSH behaviors perpetrated against the participant or witnessed by the participant as a bystander) documenting WSH among women (as high as 53%) and men (as high as 45%) in California and among women (as high as 65%) and men (as high as 68%) in Michoacán. Women farmworkers in California reported WSH experiences exceeding those of men. Reported WSH experiences in Michoacán were similar for men and women. Farmworkers identified WSH perpetrators as coworkers more than leadership. The frequency of exposure ranged from daily, weekly, monthly, and up to multiple times a year. Of 46 direct inquiry-based WSH incidents, only one perpetrator was punished, and at least half of all victims said they were forced to change their jobs. The findings of this study inform the development of WSH prevention efforts, such as education tools, support for efforts to facilitate reporting, protections against retaliation for workers, and promoting accountability for perpetrators. This information supports the promotion of policy recommendations and preventive approaches for WSH.

Outbreak Associated with SARS-CoV-2 B.1.617.2 (Delta) Variant in an Elementary School - Marin County, California, May-June 2021.

On May 25, 2021, the Marin County Department of Public Health (MCPH) was notified by an elementary school that on May 23, an unvaccinated teacher had reported receiving a positive test result for SARS-CoV-2, the virus that causes COVID-19. The teacher reported becoming symptomatic on May 19, but continued to work for 2 days before receiving a test on May 21. On occasion during this time, the teacher read aloud unmasked to the class despite school requirements to mask while indoors. Beginning May 23, additional cases of COVID-19 were reported among other staff members, students, parents, and siblings connected to the school. To characterize the outbreak, on May 26, MCPH initiated case investigation and contact tracing that included whole genome sequencing (WGS) of available specimens. A total of 27 cases were identified, including that of the teacher. During May 23-26, among the teacher's 24 students, 22 students, all ineligible for vaccination because of age, received testing for SARS-CoV-2; 12 received positive test results. The attack rate in the two rows seated closest to the teacher's desk was 80% (eight of 10) and was 28% (four of 14) in the three back rows (Fisher's exact test; p = 0.036). During May 24-June 1, six of 18 students in a separate grade at the school, all also too young for vaccination, received positive SARS-CoV-2 test results. Eight additional cases were also identified, all in parents and siblings of students in these two grades. Among these additional cases, three were in persons fully vaccinated in accordance with CDC recommendations (1). Among the 27 total cases, 22 (81%) persons reported symptoms; the most frequently reported symptoms were fever (41%), cough (33%), headache (26%), and sore throat (26%). WGS of all 18 available specimens identified the B.1.617.2 (Delta) variant. Vaccines are effective against the Delta variant (2), but risk of transmission remains elevated among unvaccinated persons in schools without strict adherence to prevention strategies. In addition to vaccination for eligible persons, strict adherence to nonpharmaceutical prevention strategies, including masking, routine testing, facility ventilation, and staying home when symptomatic, are important to ensure safe in-person learning in schools (3).

Use of SMS-linked electronic surveys for COVID-19 case investigation and contact tracing - Marin County, CA, USA.

OBJECTIVES: We sought to quantify the proportion of contacts reported by persons with COVID-19 through a short message service (SMS)-linked survey in comparison to the proportion of contacts reported during a follow-up phone-interview. We also sought to assess improvement in contact tracing timeliness associated with sending SMS-linked surveys. STUDY DESIGN: During December 4-15, 2020, persons identified as COVID-19 cases whose data was entered into Marin County's contact tracing database on even days received a SMS-linked survey and persons whose data was entered on odd days did not; all were called for case investigation and contact tracing. Chi-square test and Fisher's exact test were used to compare demographic data. Chi-square test was used to contrast categorical outcomes, and Wilcoxon's rank-sum test was used for continuous outcomes. RESULTS: Among 350 SMS-linked survey recipients, 85 (24%) responded and 4 (1%) reported contacts using the survey; an additional 303 contacts were reported during phone interviews. Without phone interviews, 99% of reported contacts would have been missed. There was no meaningful difference between study arms in the proportion of contacts notified within 48 h. CONCLUSIONS: This SMS-linked survey had low participation and was not useful for identifying contacts. Phone interviews remained crucial for COVID-19 contact tracing.

Risk for Coccidioidomycosis among Hispanic Farm Workers, California, USA, 2018.

To determine occupational risk factors for coccidioidomycosis among adult Hispanic outdoor agricultural workers in California, USA, we conducted a case-control study of workers seen at the Kern County medical facility and referred to the public health laboratory for coccidioidomycosis serologic testing. Participants completed an interviewer-administered health and work questionnaire. Among 203 participants (110 case-patients with positive and 93 controls with negative serologic results), approximately half were women, and more than three quarters were born in Mexico. Associated with coccidioidomycosis were self-reported dust exposure and work with root and bulb vegetable crops. A protective factor was leaf removal, an activity associated with grape cultivation. We conclude that subjective dust exposure and work with root and bulb vegetable crops are associated with increased risk for coccidioidomycosis among Hispanic farm workers. The agricultural industry should evaluate and promote dust-reduction measures, including wetting soil and freshly harvested products.

Comparison of unsupervised home-based pulmonary rehabilitation versus supervised hospital outpatient pulmonary rehabilitation in patients with chronic obstructive pulmonary disease.

Background: Pulmonary rehabilitation (PR) is an effective treatment in patients with chronic obstructive pulmonary disease (COPD) but still underutilized. The aim of this study was to compare unsupervised home PR with supervised outpatient PR in terms of various clinical variables in COPD patients.Methods: We conducted retrospective study consisting of 247 patients with COPD who were categorized into three group. 127 patients underwent unsupervised home PR, of whom 60 (47%) completed program (finishers), 67(53%) were lost to follow-up (non-finishers), 120 completed supervised outpatient PR. We compared baseline, post-treatment changes in demographic, clinical variables.Results: Sex, age were statistically similar between groups. Finishers of home PR had higher exercise capacity (p = 0.003), quality of life (p = 0.045), FEV1 (p = 0.001), lower pack-year smoking (p < 0.001) than outpatient PR.After home PR, exercise capacity (p < 0.05), quality of life (p < 0.001), dyspnea(p < 0.05), anxiety (p < 0.001), depression (p < 0.001) were improved except endurance shutte test. Improvements in exercise capacity (p < 0.05), quality of life (p < 0.001), dyspnea (p = 0.023), anxiety (p < 0.001), depression (p = 0.001) scores were different between completed PR programs, in favor of supervised outpatient PR. Non-finishers of home PR had more pack-year smoking than finishers of home PR (p = 0.039); other baseline parameters were similar.Conclusion: Unsupervised home PR was effective in terms of improving exercise capacity, quality of life, dyspnea, psychological status, but less than supervised outpatient programs.

Abortion and public health: Time for another look.

Four decades after Roe v. Wade, abortion remains highly contentious, pitting a woman's right to choose against a fetal claim to life. Public health implications are staggering: the US annual total of more than one million induced abortions equals nearly half the number of registered deaths from all causes. Sentiment regarding abortion is roughly evenly split among the general public, yet fundamental debate about abortion is largely absent in the public health community, which is predominantly supportive of its wide availability. Absence of substantive debate on abortion separates the public health community from the public we serve, jeopardizing the trust placed in us. Traditional public health values-support for vulnerable groups and opposition to the politicization of science-together with the principle of reciprocity weigh against abortion. Were aborted lives counted as are other human lives, induced abortion would be acknowledged as the largest single preventable cause of loss of human life. Lay Summary: Four decades after Roe v. Wade, abortion remains highly divisive. Public sentiment regarding abortion is roughly evenly split, yet fundamental debate is largely absent in the public health community, which supports abortion's wide availability. Absence of substantive debate separates the public health community from the public it serves. Traditional public health values-support for vulnerable populations and opposition to politicization of science-and the principle of reciprocity ("the Golden Rule") weigh against abortion. Were aborted lives counted as are other human lives, induced abortion would be acknowledged as the largest single preventable cause of loss of human life.

Farmworker Housing in the United States and Its Impact on Health.

Farmworkers in the United States occupy a range of housing, including both on- and off-farm family and communal dwellings. As the farmworker population is becoming more settled, housing needs are changing. Existing regulations designed originally for grower-supplied migrant housing may need to be expanded. Much of farmworker housing is in poor condition, and likely linked to negative mental and physical health outcomes of residents because of exposures to crowding; mold, mildew, and other allergens; pesticides; and structural deficiencies. The existing research literature, both on housing conditions and their associations with farmworker health, is sparse, and large areas of the country and significant domains of health are omitted. This paper reviews this literature and formulates research and policy recommendations for addressing these deficiencies.

Cohort study of physical activity and injury among Latino farm workers.

INTRODUCTION: This study characterized physical activity and its association with injury among Latino farm workers. METHODS: An interviewer-administered questionnaire was used to collect baseline and follow-up data on 843 and 640 Latino farm workers, respectively. Participants were 18-55 years old, engaged in farm work and residing in Mendota, CA at baseline interview. The questionnaire assessed self-reported physical activity and risk of injury. RESULTS: The 12 month prevalence of injury decreased from 9.0% at baseline to 6.9% at follow up interview. In GEE models adjusted for age, follow-up time, gender, smoking, income and years working in agriculture, poor/fair self-assessed health status (OR = 1.82, 95% CI: 1.18-2.82) and 2-3 hr per day of sitting/watching TV/using a computer (OR = 0.50, 95% CI: 0.30-0.83) were significantly associated with injury. CONCLUSIONS: Physical activity was not associated with injury in this population. Efforts to reduce injuries should focus on known risk factors such as poor health status.

Region of birth, sex, and reproductive health in rural immigrant latino farmworkers: the MICASA study.

PURPOSE: Characterize sexual and reproductive health among immigrant Latino farmworkers. METHODS: We surveyed 806 immigrant Latino farmworkers from Mexico and Central America in a rural agricultural community in California's Central Valley. FINDINGS: A total of 556 respondents were born in Mexico (272 men, 284 women) and 250 in Central America (135 men, 115 women). The majority entered the United States as young adults, with median age at immigration ranging from 20 (Mexican-born men) to 24 (Central American-born women). Nearly 95% of respondents were married or cohabiting. Median age for sexual debut was 18 for women and was younger for men (adjusted mean difference: -2.1 years, 95% CI: -2.6 to -1.7). Median number of lifetime sexual partners was 1 for women and greater for men (adjusted mean difference: 2.0 partners, 95% CI: 1.3-2.7). Contraception use was less likely among men and among Central American women compared to Mexico-born women. Among sexually active persons not using contraception, the most common reasons for nonuse were "Don't want to"/"Don't like any" followed by desire to become or being pregnant. Women reported a median of 3 pregnancies; there were no significant differences based on respondents' region of birth. CONCLUSIONS: This group of Latino immigrants demonstrated behaviors conducive to reproductive health: late sexual debut, few lifetime sexual partners, and high prevalence of marriage. Preventive education campaigns should focus on maintaining healthy behaviors, especially in men. Identifying groups with common provenance and cultural heritage may aid in maximizing acceptability and effectiveness of prevention programs.

An estimate of the U.S. government's undercount of nonfatal occupational injuries and illnesses in agriculture.

BACKGROUND: Debate surrounds the accuracy of U.S. government's estimates of job-related injuries and illnesses in agriculture. Whereas studies have attempted to estimate the undercount for all industries combined, none have specifically addressed agriculture. METHODS: Data were drawn from the U.S. government's premier sources for workplace injuries and illnesses and employment: the Bureau of Labor Statistics databanks for the Survey of Occupational Injuries and Illnesses (SOII), the Quarterly Census of Employment and Wages, and the Current Population Survey. Estimates were constructed using transparent assumptions; for example, that the rate (cases-per-employee) of injuries and illnesses on small farms was the same as on large farms (an assumption we altered in sensitivity analysis). RESULTS: We estimated 74,932 injuries and illnesses for crop farms and 68,504 for animal farms, totaling 143,436 cases in 2011. We estimated that SOII missed 73.7% of crop farm cases and 81.9% of animal farm cases for an average of 77.6% for all agriculture. Sensitivity analyses suggested that the percent missed ranged from 61.5% to 88.3% for all agriculture. CONCLUSIONS: We estimate considerable undercounting of nonfatal injuries and illnesses in agriculture and believe the undercounting is larger than any other industry. Reasons include: SOII's explicit exclusion of employees on small farms and of farmers and family members and Quarterly Census of Employment and Wages's undercounts of employment. Undercounting limits our ability to identify and address occupational health problems in agriculture, affecting both workers and society.

Work-related injuries and fatalities on dairy farm operations-a global perspective.

Agriculture is among the most hazardous sectors for workers globally, and dairy farming has been associated with a high risk of injury among workers in several countries. The purpose of this paper is to provide an update on what is known about modern dairy farms and related injuries and fatalities in different regions of the world. As in other sectors of agriculture, fatalities appear to be associated with heavy equipment usage, whereas injuries occur at higher rates with animal production, specifically cattle and milk production. Dairy farming is associated with higher rates of injury as compared with other industrial sectors, but a lack of work-related injury reporting continues to be an issue in several countries. Worker fatality associated with heavy equipment use is not a new observation (e.g., tractors); however, manure-handling systems, livestock handling, and quad bike operation continue to be associated with worker injuries and fatalities on modern farms. Opportunities exist for improvement of safety-related equipment to reduce injury and fatality risk during worker interactions with large animals and farm equipment.

Cardiopulmonary fitness and respirator clearance: an update.

This review addresses five key questions regarding respirator clearance: What is the efficacy of different methods of respirator clearance? Which diagnostic test is most predictive of cardiac event during respirator use? Is spirometry accurate in predicting respiratory distress/insufficiency during respirator use? Is exercise tolerance testing accurate in predicting cardiac injury during respirator use? Which periodicity of clearance evaluations is most protective against cardiac event during respirator use? The medical literature was searched using PubMed, the Cochrane Library, and Web of Science. Relevant articles were reviewed to assess current recommendations and practices in respirator clearance. Between the years 1970 and 2011, 144 articles were identified, and 21 were included in this review. Current recommendations for respirator clearance are based on consensus rather than outcome studies, and opinions differed between expert sources. Many authors observed the need for cost-effective respirator clearance, but none proposed evidence-based strategies. Prospective studies on respirator clearance that evaluate cardiac and pulmonary outcomes are necessary to establish an evidence base for improving the validity, efficiency, and consistency of respirator clearance testing.

A registry-based cohort study of pulmonary tuberculosis treatment outcomes in Istanbul, Turkey.

The aim of this study is to evaluate the treatment outcomes and identify factors associated with adverse tuberculosis treatment outcomes for bacteriologically confirmed pulmonary tuberculosis. Treatment outcomes of pulmonary tuberculosis were evaluated retrospectively among 11,186 smear- and/or culture-positive patients treated between 2006 and 2009 in Istanbul, Turkey. Adverse treatment outcomes were identified in 1,010 (9.0%) patients including death (1.8%), treatment default (6.1%), and treatment failure (1.1%). Factors associated with adverse treatment outcomes included being born abroad (odds ratios [OR], 5.38; 95% confidence intervals [CI], 3.67-7.91), history of tuberculosis treatment (OR, 3.77; 95% CI, 3.26-4.36), age > 65 years (OR, 2.79; 95% CI, 2.21-3.53), and male gender (OR, 1.91; 95% CI, 1.59-2.27). Death was most strongly associated with age > 65 years (OR, 45.1; 95% CI, 27.0-75.6), followed by treatment default with history of interrupted treatment (OR, 11.6; 95% CI, 8.94-15.1), and treatment failure with prior history of treatment failure (OR, 17.1; 95% CI, 6.97-41.6). Multidrug resistance was strongly associated with adverse treatment outcomes (OR, 10.8; 95% CI, 8.02-14.6). Age > 65 years, male sex, being born abroad, and history of treatment failure were found to be risk factors for adverse treatment outcomes. Hence, patients with any of these characteristics should be carefully monitored and treated aggressively.

Agricultural injury in California Hispanic farm workers: MICASA follow-up survey.

The authors report here results from the first follow-up survey of the Mexican Immigration to California: Agricultural Safety and Acculturation (MICASA) cohort of community-dwelling immigrant Hispanic farm workers in California's Central Valley. Among 560 participants the authors observed cumulative 1-year injury incidence of 6.6% (all injuries) and 4.3% (agricultural injuries). Increased prospective injury risk was associated with males, US birth, years lived in the United States, family income, and poor self-rated health. Agricultural injuries were associated most frequently with being struck by an object, falls, and cutting instruments, whereas over two thirds of nonagricultural injuries involved motor vehicles. Prevention should focus on safe handling of tools and materials, falls, and motor vehicle safety.

Agricultural work and chronic musculoskeletal pain among Latino farm workers: the MICASA study.

BACKGROUND: Agriculture poses varied dangers to hired farm workers in the U.S., but little information exists on occupational risks for chronic musculoskeletal pain. We examined common work positions, such as kneeling, carrying heavy loads, and repetitive motion that may increase the risk for chronic musculoskeletal pain. METHODS: MICASA is a population-based study of occupational exposures and health in hired farm workers in California. This analysis includes 759 participants, 18-55 years old, engaged in farm work and residing in Mendota, CA. Chronic pain was defined as pain lasting 6 weeks or longer at specific body sites (back, knee, hip, etc.) over the entire farm work career. RESULTS: Mean age was 37.9 years. Sixty-five percent participants were born in Mexico, 27.7% were born in El Salvador, and 4.2% were U.S-born. Chronic pain was associated with older age and female sex. After adjustment for age, years working in agriculture, and smoking, stooping/bending >30 hr/week among both men (OR = 2.49, 95% CI: 1.03-5.99) and women (OR = 2.15, 95% CI: 1.04-4.46) was associated with chronic hip pain. Driving tractors or other heavy farm equipment >60 hr/week was associated with increased odds of chronic hip pain (OR = 2.16, 95% CI: 1.02-4.54) among men. We also observed significant associations with kneeling or crawling >35 hr/week among women for both chronic back pain (OR = 2.96, 95% CI: 1.27-6.93) and knee pain (OR = 3.02, 95% CI: 1.07-8.50), respectively. CONCLUSIONS: Chronic musculoskeletal pain is prevalent among farm workers and is associated with common work positions. Further research should focus on developing preventive interventions for tasks associated with increased pain risk. These interventions should be targeted to specific types of agricultural tasks.

Willingness to provide behavioral health recommendations: a cross-sectional study of entering medical students.

BACKGROUND: Behavioral factors contribute importantly to morbidity and mortality, and physicians are trusted sources for information on reducing associated risks. Unfortunately, many clinical encounters do not include prevention counseling, and medical school curriculum plays an important role in training and promoting such counseling among medical students. METHODS: We surveyed all 93 freshman medical students at entry to the University of California, Davis School of Medicine in 2009 to evaluate baseline knowledge of population health principles and examine their approach to clinical situations involving four common behavioral risk factors illustrated in brief clinical vignettes: smoking, alcohol use in a patient with indications of alcoholism, diet and exercise in an overweight sedentary patient, and a 16-year-old contemplating initiation of sexual intercourse. Based on vignette responses, we assessed willingness to (1) provide information on risks, (2) recommend elimination of the behavior as the most efficacious means for reducing risk, (3) include strategies apart from elimination of the behavior for lowering risk (i.e., harm reduction), and (4) assure of their intention to continue care whether or not recommendations are accepted. RESULTS: Students answered correctly 71.4 % (median; interquartile range 66.7 % - 85.7 %) of clinical prevention and population health knowledge questions; men scored higher than women (median 83.3 % vs. 66.7 %, p<0.02). Students showed high willingness to provide information and strategies for harm reduction apart from risk elimination, while respecting patient autonomy. Willingness to recommend elimination of high-risk behaviors "always or nearly always" was high for smoking (78.5 %), alcohol consumption in a patient with indications of alcoholism (64.5 %), and diet and exercise in a sedentary and overweight individual (87.1 %), and low for the 16-year-old considering initiating sexual intercourse (28.0 %; Friedman test, p<0.001). Willingness was not associated with the respondent's background knowledge of population health principles or gender. CONCLUSION: Students showed high willingness to educate and respect patient autonomy. There was high willingness to recommend elimination of risk behaviors for smoking, alcohol, and poor diet/exercise, but not for sexual intercourse in an adolescent considering sexual debut. Further research should address promoting appropriate science-based preventive health messages, and curriculum should include explicit discussion of content of recommendations.

Ethnic and gender differences in farm tasks and safety practices among rural California farm youth.

Agricultural work is hazardous and is common among rural youth, especially those living on farms or ranches. Previous work has shown differences in farm work and injury patterns between boys and girls, but little data exist addressing ethnic differences. This study examined ethnic and gender differences in farm tasks, safety attitudes, and use of protective measures among rural California youth working on farms or ranches. The University of California, Davis Youth Agricultural Injury Study is a longitudinal study focusing on agricultural work experience among youth enrolled in an agricultural sciences curriculum in 10 public high schools in California's Central Valley during the 2001-2005 school years. Using cross-sectional data from the initial entrance survey, we studied 946 participants who reported farm work in the previous year. Median annual hours of farm work varied significantly between boys and girls (p < 0.001) and between ethnic groups (p < 0.05) (Hispanic boys: 624 hr; Hispanic girls: 189 hr; White/Other boys: 832 hr; White/Other girls: 468 hr). Girls and Hispanic students were less likely than boys and White/Other students, respectively, to perform hazardous tasks involving tractors, machinery, and chemicals. Median age for initiating work on selected hazardous tasks was up to 3 years later for Hispanic students. Use of task-appropriate safety measures was low in all groups for most hazardous tasks. Boys were more likely than girls to use task-appropriate safety measures, with the exception of seatbelt use when in a car or truck. Hispanic students were more likely than White/Other students to employ safety measures. Girls and Hispanic youth worked fewer farm hours and had reduced exposure to selected hazardous tasks. Use of task-appropriate safety measures was low for all groups but increased for Hispanic students. Further study should explore reasons for low use of safety measures and develop educational efforts to bring about social norm changes promoting their use.

Agricultural injury among rural California public high school students.

OBJECTIVES: The University of California, Davis Youth Agricultural Injury Study characterized the farm work and agricultural injury experience among rural California Central Valley public high school students enrolled in an agricultural sciences curriculum. METHODS: We conducted a cross-sectional survey of agricultural injury among students from 10 California Central Valley high schools during the 2001-2005 school years. RESULTS: Of 1,783 subjects, 946 (53.1%) reported farm work in the previous year, including 97 (10.3%) reporting at least one farm work-related injury in the preceding year. After adjustment for sex, ethnicity, and hours spent in farm work, injury risk was associated with large-animal operations (OR 4.15; 95%CI: 1.18, 14.65), feeding large animals (OR 2.38; 95%CI: 1.15, 4.96), mixing chemicals (OR 1.86; 95%CI: 1.15, 3.03), welding (OR 2.09; 95%CI: 1.17, 3.72), non-use of seatbelts, and frequent riding in the back of an uncovered pick-up truck. Risky attitudes toward farm safety were significantly associated with injury. Girls were more likely to suffer an animal-related injury and boys to suffer injury related to motor vehicles, machinery, or tool use. CONCLUSIONS: Adolescents are at similar risk to adults for agricultural injury. Although limitations on hazardous tasks and time spent on farm work are likely to be the most efficacious means for reducing injury, education will play an important role. Educational measures should include inculcating healthy safety-related attitudes and focus on hazardous tasks, such as those involving animals (for girls) and motor vehicles and machinery (for boys).