Cooling Interventions Among Agricultural Workers: A Randomized Pilot Study Open Access

Chicas, Roxana (Spring 2020)

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Background: Adverse health effects among agricultural workers due to chronic heat exposure have been characterized in the literature as not only due to high ambient temperatures but also due to intensive manual labor in hot and humid conditions. The US Centers for Disease Control and Prevention reports that the average annual heat-related death rate among agricultural workers is nearly 20 times greater than that of the overall US workforce. This study builds on the GirasolesStudy, initiated in 2014 in partnership with the Farmworker Association of Florida (FWAF) in response to the Florida agricultural community’s ongoing concerns about the impact of chronic heat exposure on their health.

Methods: In April-May of 2018 and 2019 we conducted pilot studies in Florida, to examine workplace personal cooling gear interventions that could prevent HRI. A sample of 84 agricultural workers in Florida were randomized to 1 of 4 groups: 1) no intervention, clothing as usual; 2) cooling bandana; 3) cooling vest; and 4) both the cooling bandana and cooling vest. Biomonitoring equipment worn by the participants included core body temperature and heart rate monitor belts, and an accelerometer to capture physical activity.

Results: A total of 78 agricultural workers completed one intervention workday. Core body temperature differences were observed; the bandana group had 38% of participants exceeded 38.0°C, followed by 46% in the control group, 53% in combination group, and the vest group had the highest proportion with 60%. Logistic regression analysis revealed the bandana group had lower odds of exceeding a core body temperature of 38.0°C (OR 0.7, CI90 [0.2, 3.2]) and the vest group had higher odds of exceeding 38.0°C (OR 1.8, CI90 [0.4, 7.9). The use of both the cooling vest and bandana (combination group) showed the effect was little different from the control group (OR 1.3, CI90 [0.3, 5.6].

Conclusion: This is the first field-based study to pilot cooling intervention among agricultural workers in the US using biomonitoring equipment. This study found that agricultural workers that used a bandana while working in a hot environment has the potential to be protective against exceeding a core body temperature of 38.0°C.

Table of Contents

Chapter 1: Introduction 1

Problem Statement 1

Aims of Study 3

Background 4

Conceptual Framework 7

Chapter Two: Systematic Review 10

Abstract 10

Introduction 11

Methods 13

Results 14

Discussion 28

Conclusion 32

Chapter Three: Randomized Pilot Results 37

Abstract 37

Introduction 38

Methods 41 

Results 46

Discussion 53

Conclusion 56

Chapter Four: Qualitative Pilot Results 57

Abstract 57

Introduction 58

Methods 60

Results 62

Discussion 69

Conclusion 73

Chapter Five: Summary of Results and Conclusion 74

Clinical Implications 77

Research Implications. 78

Limitations 78

Conclusion 79

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