Comparison of Agricultural Injury and Fatality Characteristics Obtained from Media Monitoring Versus Official Statistics

Objective of project: 1. Compare the characteristics of fatal injuries reported by CFOI and CS-CASH media monitoring 2. Analyze the agreement between CFOI reported injuries and CS-CASH media monitoring fatal injuries Planning/Research Method: Background: The Bureau of Labor Statistics, Census of Fatal Occupational Injuries (CFOI) provides statistics on occupational fatalities, but information on individual cases is not reported. The Central States Center for Agricultural Safety and Health (CS-CASH) tracks media reports of agricultural injury and fatality cases to augment CFOI data. Methods: Data was obtained from variety of sources. The primary data source was Google Alerts and other sources includes press clippings and local media reports. The key words used for selecting relevant articles were “farm accident”, “farm incident”, “farm death”, “ranch accident”, “ranch death” and “livestock. All agricultural related incidents occurring in Nebraska, Iowa, Minnesota, South Dakota, North Dakota, Missouri and Kansas between 2012-June 2016 were selected for analysis. Data was obtained from CFOI database for different type of injury events and compared to those obtained from different media sources using 2 independent t test. An association between fatalities or farm injuries and other characteristics was determined in a using a Pearson Chi square and a multivariate analysis using a multiple logistic regression model. Results: We found significant differences in CS-CASH media monitoring data between fatal and non-fatal injuries. Google alerts included a higher proportion of roadway incidents, …, …, and … compared to data from press clips from print media. CFOI data included a higher proportion of …, …., and … fatalities compared to data from CS-CASH media monitoring.We found significant differences in CS-CASH media monitoring data between fatal and non-fatal injuries (p\u3c0.0001). CFOI data included a higher proportion of injuries from struck, contact and fall when compared to CS-CASH media monitoring data. However, there is no significant difference between the CFOI data and the CS-CASH media monitoring of fatal injury data for “caught” (p=0.094) Conclusion: This study suggests an agreement between CFOI data and media monitoring data for fatal injury events due to being caught in running equipment.https://digitalcommons.unmc.edu/coph_pres/1002/thumbnail.jp

Factors Associated with Fatalities in Production Agriculture

Background: Studying the work environment and demographics of agricultural workers involved in fatal incidents can provide valuable information on the cause of fatalities and lead to better prevention measures. Objectives: To determine populations at risk of fatalities and the determinants of fatalities in production agriculture. Method: Agricultural injury and fatality data were obtained from Press clippings and Google alerts covering seven Midwest States (SD, ND, MN, IA, NE, KS and MO). Google Alerts were collected based on key words including: “farm accident”, “farm incident”, “farm death”, “ranch accident”, ”ranch incident”, “ranch death”, “ATV farm death”, “ATV ranch death”, “livestock death”, as well as other descriptors. Articles from Google Alerts were screened. Relevant articles were analyzed, and data were then extracted and added to the database. Differences in demographic and characteristics between fatal and non-fatal injuries were compared within the CS-CASH media monitoring database using the chi-square and logistic regression model. Results: A total of 1048 agricultural-related injuries including 586(56%) non-fatal cases and 462 (54.16%) fatalities were collected between 2011 to 2017 across the seven Midwest states by CSCASH monitoring database. We found that fatality was significantly associated with; age group (p\u3c0.0001), type of injury event (p\u3c0.0001), source of injury (p=0.01), time of injury (p=0.0018), activities during injury (p=0.0002), place of injury (p\u3c0.0001) and gender (p=0.0004) in a univariate analysis. It was further discovered in a multiple logistic regression that age groups, time and the place of injury were good predictors of fatalities. Conclusion: This study suggests that place of injury, time of injury and age of the victims were possible determinants of fatalities and males, elderly and the infants had more fatalities in agricultural production industry.https://digitalcommons.unmc.edu/coph_pres/1004/thumbnail.jp

Effect of Nitrosamine (NNAT) on Embryogenesis: Evidence from a Study Using Avian Embryos Exposed to NNAT

Background Birth defects are a known cause of infant death in the United States with higher rates in the Midwest perhaps due to higher use of agrichemicals for farm activities. Nitrate and atrazine are two of the most prevalent agrichemicals contaminating drinking water supplies. When ingested together, in the acidic environment of the human stomach, they can react to form a nitrosamine, NNAT. Many nitrosamines are known to be mutagenic, carcinogenic and teratogenic. Significance Preliminary studies have suggested that NNAT is a teratogen and mutagen. Several other agrichemical compounds have been detected in Nebraska groundwater wells that have the potential to nitrosate and studies are underway to evaluate the risk of adverse birth outcomes associated with exposure to these compounds. In this study, we evaluated growth in chick embryos after exposure to NNAT. Hypothesis We hypothesize that the embryo exposed to NNAT would have delayed development compared to unexposed embryos. Experimental design Three groups of eggs were observed in the study: the treatment group was treated with different doses of NNAT dissolved in Dimethyl sulfoxide (DMSO), the vehicle control group were treated with only DMSO and the untreated group (control). The air sac of the treatment groups was injected with varying concentrations of NNAT at one time to stimulate an acute response and at different times for a chronic response. Result/Data: All analysis was done on SAS 9.4. The effect of treatments on the weight and survival of the embryos were determined using analysis of covariance (ANCOVA) and multiple logistic regression respectively. The effect of treatment was found to be significant on the embryo treated with NNAT after adjusting for the effect of the positions of the eggs during incubation (p\u3c0.0001). Embryos that were untreated (controls) had the highest weight (weight=0.34g), and as the dose of NNAT was increased during treatment the weight of the embryo decreased significantly after incubation for 5 days : 0.245 µmol/l of NNAT (weight=0.15g, p=0.0009), 1.11 µmol/l of NNAT (weight=0.13g, p=0.004), 2.22 µmol/l of NNAT (weight=0.11g, p=0.01) and 3.33 µmol/l of NNAT (weight=0.12g, p=0.01). Also, it was found that the odds of survival among the embryo decreased linearly with increased dose when treated with NNAT as compared to the untreated embryos: 1.11 µmol/l of NNAT vs untreated (OR=0.250 95% C.I. 0.078-0.799), 2.22 µmol/l of NNAT vs. untreated (OR=0.120 95% C.I. 0.042-0.347) and 3.33 µmol/l of NNAT vs untreated (OR=0.106 95% C.I. 0.036-0.311) Conclusion: This study has revealed that weight and odds of survival of embryo exposed to NNAT decreased after 5 days of incubation. Dose-effect of the treatment was also observed during the development of embryos exposed to NNAT. Additional studies, however, is needed to evaluate the toxic effects of DMSO on the chick’s embryo before a conclusion can be reached.https://digitalcommons.unmc.edu/coph_pres/1008/thumbnail.jp

Effect of N-nitrosoatrazine on Embryogenesis in Avian Embryos

Preliminary studies suggest that the nitrosamine N-nitrosoatrazine (NNAT) is teratogenic and mutagenic. We hypothesized that the embryos exposed to NNAT would have higher mortality and lower growth rate compared to unexposed embryos. In this study, we evaluated growth and mortality in chick embryos after exposure to NNAT dissolved in dimethyl sulfoxide (DMSO). The study was divided into three experiments depending treatment design. First, the effect of DMSO on embryo growth and survival was tested. Second, we compared growth and survival between embryos treated with DMSO, 50:50 DMSO:water and NNAT at 0.245 µmol/l. Finally, we compared growth and survival between embryos treated with DMSO and varying doses of NNAT (1.11 µmol/l, 2.22 µmol/l, 3.33 µmol/l) dissolved in DMSO. Based on this, we determine the LD50 (lethal dose for 50% of a test population) for NNAT. In terms of mortality, the first experiment shows that there is no effect of DMSO compared to water and blank, but the third experiment shows that there is a linear relationship between NNAT doses where high NNAT dose level will reduce the survival rate of the embryos. From this relationship, we determine that LD50 to be 2. 85µmol/l. We continue the analysis on the survive embryos and reveals that DMSO and NNAT had no effect on the growth of embryos in all three experiments.https://digitalcommons.unmc.edu/coph_pres/1010/thumbnail.jp

An Analysis of Correlation Between Agrichemical Contaminated Wells and Birth Defects in Nebraska

Background: Evidences that agrichemicals might be associated with the incidence of birth defects are inconsistent. Objectives: Examine whether Triazine, Acetanilide, Carbamothioate, Nitrate, Trifluralin and Uracil present in well-water are associated with birth defect rates in Nebraska Counties Identify the well types contaminated with these pesticides. Methods: Birth defects data obtained from Nebraska Department of Human and Health Services were merged with data on wells tested for agrichemicals obtained from Quality-Assessed Agrichemical Contaminant Database for Nebraska Ground Water. The 33 contaminants sampled from the wells were sub classified into 6 predictors and expressed as percentages for analysis in a multiple regression model with birth defect rates as the response variable. The pesticides sampled from the wells were also categorized into parent and degradate to examine the nature of pesticide associated with birth defects. Due to multicollinearity, triazine, acetanilide and trifluralin were summed together. Results The percentage for triazine and nitrate in domestic wells were 10.6% and 21.5% respectively. Birth defect rates were discovered to correlate with triazine (r= 0.21 p=0.041). triazine- acetanilide-trifluralin together was found to be linearly associated with birth defect rates in the multiple linear regression model (p=0.012). A stronger correlation was found between the parent contaminants and birth defect rates(r=0.22 p=0.034) than the degradate. (r=0.15 p=0.163). Conclusion: This study suggests an association between birth defect and percent of wells positive for agrichemical compounds. However, this association does not imply causation but provides direction for future investigation.https://digitalcommons.unmc.edu/coph_pres/1003/thumbnail.jp

Birth outcomes and water: A multidisciplinary study

Evidence that agrichemicals are associated with the incidence of birth defects is inconsistent. We examined whether nitrate and nitrosatable agrichemicals present in well water are associated with birth defect rates in Nebraska counties. Birth defect data from the Nebraska Department of Health and Human Services, 2005-2014, were merged with well data obtained from the Quality-Assessed Agrichemical Contaminant Database for Nebraska Ground Water (1977-2014). Nebraska counties with higher rates of birth defects had a greater prevalence of agrichemicals in well water. Of the 33 contaminants sampled from different well types, nitrate and atrazine were of interest. Birth defect rates were negatively correlated with nitrate-positive wells and directly correlated with atrazine positive wells. After stratification by well types (domestic and public wells) we found the highest correlation between nitrate+atrazine positive wells as compared to wells contaminated with either nitrate or atrazine. This study suggests stronger association between birth defects and maternal exposure to nitrate+atrazine when compared to maternal exposure to only nitrate or atrazine in drinking water. This association does not imply causation but provides direction for further investigation.https://digitalcommons.unmc.edu/coph_pres/1011/thumbnail.jp

Role of Liver Stiffness and Alcohol on HBV Infection Pathogenesis

Hepatitis B Virus (HBV) is an infection that specifically targets hepatocytes and persistence of infection leads to inflammation and liver injury. The metabolism of alcohol is also known to cause injury and inflammation in the liver. The extent of liver damage can be analyzed by determining the pressure of the tissue with an ultrasound. As you go from a healthy liver to a fibrotic liver, the pressure increases from around 2 kPa to greater than 12.5 kPa. Previous studies have found that liver stiffness affects the primary hepatocyte function and cell interaction, but the exact mechanism behind the combined role of liver stiffness and alcohol in HBV infection is still unclear. This study aimed to determine the effect of liver stiffness and alcohol metabolism on HBV infection pathogenesis. To accomplish this aim, we used a soft and stiff liver model engineered specifically to a 2 kPa (healthy liver tissue) and 25 kPa pressure (fibrotic liver tissue). HBV transfected HepG2.2.15 cells were plated on these liver model plates. To mimic alcohol metabolism, the cells were exposed to Acetaldehyde Generating System (AGS). Results showed that liver stiffness significantly increased HBV infection markers and decreased the interferon alpha signaling by up regulating USP-18. In addition, liver stiffness increased inflammasome and pro-fibrotic markers in HBV transfected cells. The combination of alcohol metabolism with liver stiffness potentiated the HBV infection. We conclude that liver stiffness impairs interferon alpha signaling thereby increasing HBV persistence, which leads to liver inflammation and fibrosis. This study of the liver environment’s role in HBV infection and alcohol metabolism paves the way to new treatment options for patients as well as introduces more accurate lab models for research.https://digitalcommons.unmc.edu/surp2021/1023/thumbnail.jp

Cervical Cancer Screening among Patients Receiving ARVs in a Resource-Limited Environment

Significance Cervical cancer is the most common cancer worldwide with increased risk among women living with HIV in a resource limited environment. Hence the need to determine factors affecting awareness, prior uptake of cervical cancer screening and willingness to screen among patients receiving Antiretroviral (ARV) drugs. Data analysis The data was collected by administered questionnaires to patients presenting for monthly ARV refills in a HIV clinic in Dodoma, Tanzania. A total of 421 women in the clinic with an average monthly income of 39 (USD) were interviewed. A total of 306 (73%) were aware of cervical cancer. Among those who were aware, 84 % (257) did not recall been screened for cervical cancer. A total of 231 (90%) expressed willingness to be screened among patients who have never screened for cervical cancer. The average years since HIV infection for the subjects was 5.4 years; average age was 44. A logistic regression model was used to examine factors associated with awareness of cervical cancer, prior uptake of screening and willingness to be screened. Urban dwellers were found to have higher odds of awareness than rural dwellers (OR: 3.68 95% CI: 2.12-6.38). Prior uptake of screening was found higher among urban vs. rural dwellers, OR: 3.43, 95% CI: 1.02-11.51. The willingness to be screened decreased with age (OR: 0.93, 95% CI: 0.88-0.97). Conclusion This study have indicated the problem of access among rural dwellers to cervical cancer screening. Willingness to screen among younger patients could be due to increased awareness of the disease among younger patients than older patients. However, the older and rural patients are at higher risk of cervical cancer and should be targeted for primary prevention. Category Advocacy and Health Policyhttps://digitalcommons.unmc.edu/coph_pres/1007/thumbnail.jp

Alcohol-Induced Lysosomal Damage and Suppression of Lysosome Biogenesis Contribute to Hepatotoxicity in HIV-Exposed Liver Cells

Although the causes of hepatotoxicity among alcohol-abusing HIV patients are multifactorial, alcohol remains the least explored “second hit” for HIV-related hepatotoxicity. Here, we investigated whether metabolically derived acetaldehyde impairs lysosomes to enhance HIV-induced hepatotoxicity. We exposed Cytochrome P450 2E1 (CYP2E1)-expressing Huh 7.5 (also known as RLW) cells to an acetaldehyde-generating system (AGS) for 24 h. We then infected (or not) the cells with HIV-1ADA then exposed them again to AGS for another 48 h. Lysosome damage was assessed by galectin 3/LAMP1 co-localization and cathepsin leakage. Expression of lysosome biogenesis–transcription factor, TFEB, was measured by its protein levels and by in situ immunofluorescence. Exposure of cells to both AGS + HIV caused the greatest amount of lysosome leakage and its impaired lysosomal biogenesis, leading to intrinsic apoptosis. Furthermore, the movement of TFEB from cytosol to the nucleus via microtubules was impaired by AGS exposure. The latter impairment appeared to occur by acetylation of α-tubulin. Moreover, ZKSCAN3, a repressor of lysosome gene activation by TFEB, was amplified by AGS. Both these changes contributed to AGS-elicited disruption of lysosome biogenesis. Our findings indicate that metabolically generated acetaldehyde damages lysosomes and likely prevents their repair and restoration, thereby exacerbating HIV-induced hepatotoxicity

Low-Level Groundwater Atrazine in High Atrazine Usage Nebraska Counties: Likely Effects of Excessive Groundwater Abstraction

Recent studies observed a correlation between estrogen-related cancers and groundwater atrazine in eastern Nebraska counties. However, the mechanisms of human exposure to atrazine are unclear because low groundwater atrazine concentration was observed in counties with high cancer incidence despite having the highest atrazine usage. We studied groundwater atrazine fate in high atrazine usage Nebraska counties. Data were collected from Quality Assessed Agrichemical Contaminant Nebraska Groundwater, Parameter–Elevation Regressions on Independent Slopes Model (PRISM), and water use databases. Descriptive statistics and cluster analysis were performed. Domestic wells (59%) were the predominant well type. Groundwater atrazine was affected by well depth. Clusters consisting of wells with low atrazine were characterized by excessive groundwater abstraction, reduced precipitation, high population, discharge areas, and metropolitan counties. Hence, low groundwater atrazine may be due to excessive groundwater abstraction accompanied by atrazine. Human exposure to atrazine in abstracted groundwater may be higher than the estimated amount in groundwater