Depression, perceived stress and nervios associated with injury in the MICASA Study, a California farm worker population

Introduction: While many studies report on the risks of agricultural injury, few have examined psychosocial factors associated with injury, especially among Latino farm workers. We examined psychological factors, including depression, perceived stress, social support and nervios that may be associated with an increased risk of injury. Methods: MICASA is a population-based study of occupational exposures and health in farm workers. An interviewer-administered questionnaire collected data on 759 Latinos, 18-55 years old, engaged in farm work and residing in Mendota, CA. The questionnaire assessed self-reported psychosocial factors and injury risk. A qualifying injury was defined as one with the need for medical care, going to a medical setting, loss of consciousness, >½ day lost work time or restricted from normal activities. Results: Mean age was 37.9 years. 65.0% of participants were born in Mexico and 27.7% were born in El Salvador. The past-year cumulative incidence of injury was 9.0%. A higher cumulative incidence of past-year injury was observed among participants older than 40 years (55.9% vs. 37.1 %), current smokers (17.7% vs. 10.7%), working in agriculture more than 11 years (65.7% vs. 52.7%), and long-term U.S. residents (more than 21 years) (58.8% vs. 42.6%). After adjusting for age, sex, and current smoking, depression (OR=5.4, 95% CI: 3.1-9.4) and nervios (OR=2.2, 95% CI: 1.3-3.8) were significantly associated with injury. Conclusions: The findings may be useful for guiding prevention and management of injury. Further cohort research to confirm the temporality of the association between psychosocial variables and injury is needed.Introduction : De nombreuses études ont examiné les risques de blessures en milieu agricole mais peu se sont intéressées aux facteurs psychosociaux associés à ces blessures, en particulier parmi les ouvriers agricoles latinos. Nous avons étudié les facteurs psychologiques, notamment la dépression, le stress ressenti, le soutien social et l'état de nervosité qui peuvent être liés à un risque accru de blessures. Méthodes : L'étude MICASA est une étude de population qui porte sur les expositions professionnelles et la santé des ouvriers agricoles. Un questionnaire rempli par un enquêteur a permis de recueillir des données sur 759 Latinos, de 18 à 55 ans, ouvriers agricoles et résidant à Mendota, en Californie. Ce questionnaire a évalué les facteurs psychosociaux auto-déclarés et le risque de blessure. Une blessure admissible a été définie comme une blessure impliquant des soins médicaux, une visite dans un établissement médical, une perte de connaissance, >½ journée d'arrêt de travail ou d'activités limitées. Résultats : L'âge moyen était de 37,9 ans. 65,0 % des participants étaient nés au Mexique et 27,7 % au Salvador. L'incidence cumulée de blessures l'année précédente était de 9,0 %. Une plus grande incidence cumulée de blessures l'année précédente a été observée parmi les participants âgés de plus de 40 ans (55,9 % vs. 37,1 %), les fumeurs (17,7 % vs. 10,7 %), ceux travaillant dans l'agriculture depuis plus de 11 ans (65,7 % vs. 52,7 %), et les résidents américains de longue durée (plus de 21 ans) (58,8 % vs. 42,6 %). Après ajustement en fonction du sexe et du tabagisme, la dépression (OR=5,4, IC à 95 % : 3,1-9,4) et l'état de nervosité (OR=2,2, IC à 95 % : 1,3-3,8) ont été associés de manière significative à des blessures.  Conclusions : Les résultats peuvent être utiles pour orienter la prévention et la prise en charge des blessures. D'autres études de cohortes sont nécessaires pour confirmer la temporalité de l'association entre les variables psychosociales et les blessures.Introducción: Aunque se han realizado numerosos estudios sobre los riesgos de lesiones en la agricultura, pocos son los que han examinado los factores psicosociales asociados a dichas lesiones, especialmente entre los trabajadores agrícolas latinos. Hemos estudiado los factores psicosociales, tales como la depresión, el estrés percibido, el apoyo social y los nervios, que pueden asociarse a un mayor riesgo de lesiones. Métodos: MICASA es un estudio de población sobre exposiciones y salud occupacionales en trabajadores agrícolas. Un cuestionario realizado por entrevistador recogió datos de 759 latinos, de entre 18 y 55 años de edad, que realizaban labores agrícolas y con residencia en Mendota (California). El cuestionario evaluaba los factores sociales y el riesgo de lesiones declarados por los encuestados. Las lesiones por las que calificaban para el estudio eran aquellas que requerían asistencia médica o la visita a un centro médico, que implicaban pérdida de conciencia o pérdida de más de medio día de trabajo o que restringían la realización de actividades normales. Resultados: La edad media era de 37.9 años. El 65,0% de los participantes eran originarios de México y el 27.7% de El Salvador. La incidencia acumulada de lesiones del año pasado fue del 9.0%. Se observó una mayor incidencia acumulada de lesiones el año pasado entre participantes de más de 40 años (55.9% contra 37.1 %), fumadores activos (17.7% contra 10.7%), que llevan trabajando en la agricultura más de 11 años (65.7% contra 52.7%) y los residentes en Estados Unidos por un  largo plazo (más de 21 años) (58.8% contra 42.6%). Tras ajustar los resultados por edad, sexo, condición de fumador, la depresión (OR=5,4; 95% IC: 3,1-9,4) y los nervios (OR=2,2, 95% IC: 1.3-3.8) se asociaron de forma importante a las lesiones. Conclusiones: Las conclusiones extraídas pueden ser de utilidad para guiar la prevención y manejo de lesiones. Es necesario realizar otros estudios de cohortes para confirmar la temporalidad de la asociación entre las variables psicosociales y las lesiones

Migration & Self-Rated Health: Comparing Occupational Cohorts in California & Spain (MICASA and ITSAL Projects)

International migration is a growing global phenomenon.  The magnitude of the global population living outside their countries of origin substantiates the value of considering potential public health issues and their population-wide burden.  As migration has yet to be generally accepted as an exposure in and of itself, and encompasses a wide range of experiences and health effects, a measure of overall health is well suited for this research. This study compares self-rated health between two independently collected occupational cohorts as part of the ITSAL study in Spain and the MICASA study in Mendota, California, USA.  We observed greater gender balance in the MICASA sample than the ITSAL sample, where there was a substantial male majority.  Mexican-born workers in the MICASA sample tended to be older, less educated, and more likely to work in agriculture than their Moroccan-born counterparts in the ITSAL study.  We also observed a higher prevalence of poor self-rated health in the MICASA sample compared to the ITSAL sample.  Differences may be due to sampling and data collection issues, cultural issues and the subjectivity of self-rated health as an outcome, as well as actual health differences.  Further research is needed to determine common and distinct migration-related public health issues.L'immigration internationale est un phénomène mondial en plein essor. Le pourcentage élevé de personnes dans le monde vivant dans un pays autre que son pays d'origine justifie l'intérêt de prendre en compte les problèmes de santé publique potentiels et le fardeau que cela implique à l'échelle de la population. Alors que l'immigration n'est pas encore généralement reconnue comme une exposition en soi, et englobe un large éventail d'expériences et d'effets sur la santé, une évaluation de la santé globale est tout à fait appropriée pour cette étude. Cette étude compare la santé auto-évaluée de deux cohortes professionnelles, les donnés ayant été recueillies indépendamment dans le cadre de l'étude ITSAL en Espagne et de l'étude MICASA à Mendota, en Californie. Nous avons observé un plus grand équilibre entre les sexes dans l'échantillon MICASA que dans l'échantillon ITSAL, dans lequel il y avait une majorité considérable d'hommes. Les ouvriers de l'échantillon MICASA nés au Mexique avaient tendance à être plus âgés, à avoir un niveau d'instruction moindre, et à être plus susceptibles de travailler dans l'agriculture que leurs homologues nés au Maroc de l'étude ITSAL. Nous avons également observé une plus forte prévalence de mauvaise santé auto-évaluée dans l'échantillon MICASA que dans l'échantillon ITSAL. Les différences peuvent être dues aux méthodes d'échantillonnage et de recueil des données, à des aspects culturels et à la subjectivité des résultats de la santé auto-déclarée, ainsi qu'à de réelles différences en matière de santé. D'autres études sont nécessaires pour déterminer les problèmes de santé publique liées à l'immigration communs et distincts.La migración internacional es un fenómeno creciente a nivel mundial. La magnitud de la población mundial que vive fuera de su país de origen justifica el valor del estudio de los problemas potenciales para la salud pública y la carga que supone para la población en general. Debido a que todavía no se ha aceptado de forma generalizada que la migración supone una exposición por sí misma y al hecho de que abarca una amplia gama de experiencias y efectos para la salud, una medición de la salud en general parece apropiada para este estudio. En este trabajo se compara la autoevaluación de la salud entre dos cohortes ocupacionales analizadas independientemente como parte del estudio ITSAL en España y el estudio MICASA en Mendota (California, Estados Unidos.). Hemos observado un mayor equilibrio entre sexos en la muestra de MICASA que en la de ITSAL, donde había una importante mayoría masculina. Los trabajadores de origen mexicano de la muestra de MICASA tendían a ser mayores, con menor nivel educativo y con mayor probabilidad de trabajar en la agricultura que los colegas de origen marroquí del estudio ITSAL. Asimismo, hemos observado una mayor prevalencia de salud deficiente en la muestra de MICASA en comparación con la muestra de ITSAL. Las diferencias pueden deberse a problemas de muestreo y de recopilación de datos, a aspectos culturales y a la subjetividad de los resultados de la autoevaluación de la salud, así como a verdaderas diferencias de salud. Asimismo, es necesario realizar otros estudios para determinar qué aspectos de salud pública relacionados con la migración se comparten y cuáles son diferentes

A Pilot Binational Study of Health Behaviors and Immigration

In the US, Mexican immigrant women often have better health outcomes than non-Hispanic white women despite a greater health risk profile. This cross-sectional pilot study compared women living in Chavinda, Michoacán (n = 102) to women who had migrated from Mexico to Madera, California (n = 93). The interview gathered information on acculturation and risk behaviors including smoking, alcohol use and number of sexual partners. The results suggest that more acculturated women living in the US are more likely to consume alcohol. US residence and higher acculturation level was marginally associated with having more than one sexual partner. There were no differences between odds of smoking among Chavinda and Madera women. While results with acculturation are not consistently significant due to small sample sizes, the results are suggestive that acculturation among immigrant Hispanic women in the US may be associated with adverse health behaviors, and selective migration seems less likely to account for these differences

Examining Nervios Among Immigrant Male Farmworkers in the MICASA Study: Sociodemographics, Housing Conditions and Psychosocial Factors

Nervios is a culturally defined condition of psychological stress with important implications for Latino health. Using epidemiological research methods, we examined the prevalence of nerviosand associated risk factors, including drug and alcohol use, acculturation, and housing conditions in a population-based study of farm worker families in Mendota, CA (the MICASA Study). A household enumeration procedure was used for sampling, and 843 individuals were interviewed in 2006–2007. In this analysis, we present data on 422 men, 381 accompanied (family) males and 41 unaccompanied males. The prevalence of nervios was 22 %, with no difference in prevalence by household status. Low family incomes, drug use, medium/high acculturation, and poor housing conditions were associated with increased odds of nervios. Self-reported poor/fair health, depressive symptoms, and high perceived stress were also associated with nervios. Since nervioshas been shown to be a clinical indicator of psychiatric vulnerability among Latinos, this analysis furthers public health goals of reducing health disparities

Depression, perceived stress and nervios associated with injury in the MICASA Study, a California farm worker population

Introduction: While many studies report on the risks of agricultural injury, few have examined psychosocial factors associated with injury, especially among Latino farm workers. We examined psychological factors, including depression, perceived stress, social support and nervios that may be associated with an increased risk of injury. Methods: MICASA is a population-based study of occupational exposures and health in farm workers. An interviewer-administered questionnaire collected data on 759 Latinos, 18-55 years old, engaged in farm work and residing in Mendota, CA. The questionnaire assessed self-reported psychosocial factors and injury risk. A qualifying injury was defined as one with the need for medical care, going to a medical setting, loss of consciousness, >½ day lost work time or restricted from normal activities. Results: Mean age was 37.9 years. 65.0% of participants were born in Mexico and 27.7% were born in El Salvador. The past-year cumulative incidence of injury was 9.0%. A higher cumulative incidence of past-year injury was observed among participants older than 40 years (55.9% vs. 37.1 %), current smokers (17.7% vs. 10.7%), working in agriculture more than 11 years (65.7% vs. 52.7%), and long-term U.S. residents (more than 21 years) (58.8% vs. 42.6%). After adjusting for age, sex, and current smoking, depression (OR=5.4, 95% CI: 3.1-9.4) and nervios (OR=2.2, 95% CI: 1.3-3.8) were significantly associated with injury. Conclusions: The findings may be useful for guiding prevention and management of injury. Further cohort research to confirm the temporality of the association between psychosocial variables and injury is needed

Demographic and migration-related risk factors for low-level smoking in a farm working sample of Latinos (the MICASA study)

Cigarette smoking is the most preventable cause of death in the U.S. Research regarding the phenomenon of low-level smoking, defined as smoking one to five cigarettes per day (CPD) on average, is increasing as its high prevalence is better recognized. The Mexican Immigration to California: Agricultural Safety and Acculturation (MICASA) study is a prospective cohort study of Latino hired farm worker families that assesses respiratory health, including patterns and behaviors of cigarette smoking. The purpose of the present analysis was to establish demographic, migration-related, and psychosocial characteristics and risk factors for low-level smoking. Seven percent of participants were current smokers, 61% of them being low-level smokers. Low-level smokers did not smoke as many days during the past month as those who smoke 6+ CPD (p=0.04). Low-level smokers were more likely than never and former smokers combined not to be married and to experience frequent mental distress. Those who smoke 6+ CPD were also more likely than never and former smokers combined to experience frequent mental distress and to be more acculturated. Low-level smokers have characteristics and risk factors that set them apart from other types of smokers. This increased understanding of low-level smokers can enhance public health education and smoking cessation programs targeted at Latinos

Migration & self-rated health: comparing occupational cohorts in California & Spain (MICASA and ITSAL Projects)

International migration is a growing global phenomenon. The magnitude of the global population living outside their countries of origin substantiates the value of considering potential public health issues and their population-wide burden. As migration has yet to be generally accepted as an exposure in and of itself, and encompasses a wide range of experiences and health effects, a measure of overall health is well suited for this research. This study compares self-rated health between two independently collected occupational cohorts as part of the ITSAL study in Spain and the MICASA study in Mendota, California, USA. We observed greater gender balance in the MICASA sample than the ITSAL sample, where there was a substantial male majority. Mexican-born workers in the MICASA sample tended to be older, less educated, and more likely to work in agriculture than their Moroccan-born counterparts in the ITSAL study. We also observed a higher prevalence of poor self-rated health in the MICASA sample compared to the ITSAL sample. Differences may be due to sampling and data collection issues, cultural issues and the subjectivity of self-rated health as an outcome, as well as actual health differences. Further research is needed to determine common and distinct migration-related public health issues.Funding for the MICASA study was provided by the National Institute for Occupational Safety and Health (2U500H007550 and RO1OH009293) and The California Endowment. Funding for the ITSAL project was provided by the Fondo de Investigación Sanitaria, Instituto de Salud Carlos III in 2005 (PI050497, PI052202, PI052334), 2006 (PI061701), and 2007 (PI0790470)

Acculturation-Related Predictors of Very Light Smoking Among Latinos in California and Nationwide

The prevalence of light smoking has increased among Latinos. The purpose of this study was to identify demographic and acculturation-related factors associated with very light smoking, defined as smoking 1-5 cigarettes per day (CPD), among Latinos in California and nationwide. Latino smokers in the 2007-2008 National Health and Nutrition Examination Survey (NHANES) or the 2009 California Health Interview Survey (CHIS) were analyzed. Logistic regression assessed factors associated with very light smoking. Among NHANES smokers, those born in Mexico or who lived fewer years in the US were more likely to be very light smokers than 6+ CPD smokers. Among CHIS smokers, those born in Mexico, in another Spanish speaking country, or who spent smaller percentages of their life in the US were more likely to be very light smokers. Findings from this study can be used to design tobacco control media campaigns that include very light smokers

Migration & self-rated health: comparing occupational cohorts in California & Spain (MICASA and ITSAL Projects)

International migration is a growing global phenomenon. The magnitude of the global population living outside their countries of origin substantiates the value of considering potential public health issues and their population-wide burden. As migration has yet to be generally accepted as an exposure in and of itself, and encompasses a wide range of experiences and health effects, a measure of overall health is well suited for this research. This study compares self-rated health between two independently collected occupational cohorts as part of the ITSAL study in Spain and the MICASA study in Mendota, California, USA. We observed greater gender balance in the MICASA sample than the ITSAL sample, where there was a substantial male majority. Mexican-born workers in the MICASA sample tended to be older, less educated, and more likely to work in agriculture than their Moroccan-born counterparts in the ITSAL study. We also observed a higher prevalence of poor self-rated health in the MICASA sample compared to the ITSAL sample. Differences may be due to sampling and data collection issues, cultural issues and the subjectivity of self-rated health as an outcome, as well as actual health differences. Further research is needed to determine common and distinct migration-related public health issues.Funding for the MICASA study was provided by the National Institute for Occupational Safety and Health (2U500H007550 and RO1OH009293) and The California Endowment. Funding for the ITSAL project was provided by the Fondo de Investigación Sanitaria, Instituto de Salud Carlos III in 2005 (PI050497, PI052202, PI052334), 2006 (PI061701), and 2007 (PI0790470)