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Potential Risk Factors for Work-Related Musculoskeletal Pain to Hired Crop Workers in the U.S. John R. Myers and Larry A. Layne National Institute for Occupational Safety and Health - PowerPoint PPT Presentation
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Potential Risk Factors for Work-Related Musculoskeletal Pain to Hired Crop
Workers in the U.S.
John R. Myers and Larry A. Layne
National Institute for Occupational Safety and Health
The findings and conclusions in this Presentation are those of the authors and do not necessarily represent the views of the National Institute for Occupational Safety and Health.
National Agricultural Workers Survey National survey of hired crop workers in the
U.S.
U.S. Department of Labor, Employment Training Administration
Began in 1989
Main focus: crop worker labor force stability, demographics, work histories, and economics
National Agricultural Workers Survey
1999-2004 NIOSH occupational health supplemental modules
Injury: 1999, 2002-2004 Musculoskeletal pain: 1999-2004 Dermatitis: 1999-2003 Health conditions: 1999-2004
asthma, diabetes, high blood pressure, tuberculosis, heart disease, urinary tract infections
Methods
Methods: NAWS
Retrospective, cross sectional study Survey of the Continental U.S.--Excludes
Hawaii and Alaska Personal interview in worker’s primary
language Conducted in a location chosen by worker Core questionnaire and supplemental modules All hired crop workers eligible Complex sampling weights
Methods
Demographic information on hired crop workers:
General: Age, Sex, Race/Ethnicity, Education, Language
Time of interview: Region, Migration pattern, US farm work experience, Health problems, Type of crop, Type of work, Socio-economic information
Chart TitleGeographic Regions Used by NAWS
East
Southeast
Midwest
Southwest
Northwest
California
Methods
Musculoskeletal pain module: Number of self-reported complaints of
pain during the past year Farm work-related events only
Methods Modeling using SAS Proc Surveylogistic
Outcome = incidence of musculoskeletal complaints divided by weeks of farm work (adjusted range to be 0 - 1)
34 statistically significant independent variables from univariate models (α=0.05)
Multivariate model of these 34 variables Backwards elimination approach
Results
Basic Survey Results
Survey response: Operator participation rate: 69% Crop worker participation rate: 94%
Number of interviewed hired crop workers just over 20,000
Musculoskeletal Pain, 1999-2004 Musculoskeletal pain complaints (MPC):
Weighted estimate = 4,021 complaints Crude incidence = 43.3 MPC/100 FTEWB
Chart TitleMultivariate Logistic Model Results
23 independent variables were associated with the incidence of musculoskeletal pain (α=0.05)
8 demographic, 5 employment , 10 socio-economic
Chart TitleMultivariate Logistic Model Results
Demographic variables: Age Sex Education Marital status Region Years of farm work in U.S. Health conditions English speaking skills
Chart TitleMultivariate Logistic Model Results
Demographic: Health conditions
Demographic: Sex
Illnesses ORadj L95% U95%
2 ≥ illnesses 2.13 1.78 2.551 illness 1.58 1.36 1.72No illnesses 1.00 --- ---
Sex ORadj L95% U95%
Female 1.66 1.47 1.87Male 1.00 --- ---
Chart TitleMultivariate Logistic Model Results
Demographic: Education
Demographic: Education
Formal Education ORadj L95% U95%
None 1.51 1. 20 1.90Any education 1.00 --- ---
Region ORadj L95% U95%
California 1.50 1.22 1.85Southeast 1.40 1.13 1.74Southwest 1.32 0.99 1.75
Midwest 1.27 1.02 1.57West 1.26 0.99 1.60
East 1.00 --- ---
Chart TitleMultivariate Logistic Model Results
Employment variables: Workers’ compensation coverage Crop currently harvesting Task currently doing Employer provided tools/equipment Employer provided clean drinking water
Chart TitleMultivariate Logistic Model Results
Employment: Workers’ compensation
Employment: Current crop worked on
Known Coverage ORadj L95% U95%
None 1.83 1.58 2.13Medical or indemnity 1.43 1.26 1.63
Medical & indemnity 1.00 --- ---
Crop ORadj L95% U95%Multiple 1.60 1.22 2.10Fruit & nuts 1.54 1.29 1.85Vegetables 1.53 1.29 1.82Field crops 1.51 1.24 1.83Horticultural 1.00 --- ---
Chart TitleMultivariate Logistic Model Results
Socio-economic variables: Migrant type Farm work income Home ownership US owned assets Housing arrangements Used unemployment insurance past year Used U.S. healthcare past 2 years Healthcare payment method Number of Social services used Below minimum wage
Chart TitleMultivariate Logistic Model Results
Socio-economic: Used U.S. health care
Socio-economic: Healthcare payment method
Used healthcare ORadj L95% U95%
Yes 1.96 1.20 3.43No 1.00 --- ---
How paid ORadj L95% U95%
Did not pay 1.99 1.36 2.91Employer/WC 1.17 1.00 1.37None used 1.19 0.68 2.07
Other insurance 1.00 --- ---
Chart TitleMultivariate Logistic Model Results
Socio-economic: Farm work income
Socio-economic: Migrant type
Income ORadj L95% U95%
None 2.18 1.63 2.91< $15,000 1.09 0.97 1.22
≥ $15,000 1.00 --- ---
Migrant type ORadj L95% U95%
Shuttle 1.72 1.44 2.06Settled 1.12 0.95 1.33
Follow the crop 1.00 --- ---
Summary
Summary The average incidence of musculoskeletal
pain complaints was even higher—43.3 complaints/100 FTEWB.
Twenty-three of 34 independent variables were significantly associated with incidence of musculoskeletal pain in multivariate model
Mixture of demographic, employment, and socio-economic variables.
Summary
Workers reporting responsible employment practices had lower odds of musculoskeletal complaints:
Told about workers’ compensation coverage
Provided fresh drinking water/cups Provided tools and equipment
Summary
Some variables suggest young/new workers have higher odds of musculoskeletal pain:
<20 years old highest adjusted odds ratio
≤ 1 year U.S. farm work No previous farm work income
Summary
Other key potential risk factors: Female worker No reported education Shuttle migrant Reporting other health issues
Future Work Work with NIOSH Ag centers, employers,
and farm worker groups to address factors associated with work-related musculoskeletal pain
Need to focus on female farm workers and new hired crop workers
Approaches need tailored to low income workers with little formal education
Limitations Cross-sectional survey Self-reported pain by farm workers Small number of farm workers covered by
the survey in some regions
Questions?