Introduction: Agricultural workers perform intense labor outside in direct sunlight and in humid environmental conditions exposing them to a high risk of heat-related illness (HRI). To implement effective cooling interventions in occupational settings, it is important to consider workers’ perceptions. To date, an analysis of agricultural workers’ experience and perception of cooling devices used in the field while working has not been published. -/- Methods: Qualitatively data from 61 agricultural workers provided details of their perceptions and experiences with cooling interventions. (...) -/- Results: The participants in the bandana group reported the bandana was practical to use at work and did not interfere with their work routine. Cooling vest group participants agreed that the vest was effective at cooling them, but the practicality of using the vest at work was met with mixed reviews. -/- Conclusion: The findings of this qualitative study support and extend existing research regarding personal cooling and heat prevention research interventions with vulnerable occupational groups. Personal cooling gear was well received and utilized by the agricultural workers. Sustainable heat prevention studies and governmental protection strategies for occupational heat stress are urgently needed to reduce the risk of heat-related morbidity, mortality, and projected climate change health impacts on outdoor workers. (shrink)

The nursing community in the United States polarized in September 2020 between Dawn Wooten's whistleblowing about forced hysterectomies at an immigration center in Georgia and the American Nurses Association's refusal to endorse a presidential candidate despite the Trump administration's mounting failures to address the public health crisis posed by the COVID‐19 pandemic. This reveals a need for more attention to political aspects of health outcome inequities. As advocates for health equity, nurses can join in recent scholarship and activism concerning the (...) political determinants of health. In this paper, we examine recent work on the political determinants of health with an aim to add two things. First, we seek to build further on the notion of “political” determinants of health by distinguishing policy and governance structures from dynamics of politicization through appeal to critical disabilities studies. Second, we seek to apply this further nuanced approach to challenge rhetorical uses of “vulnerable populations,” where this phrase serves to misrecognize systemic institutionalized forces that actively exploit and marginalize people and groups. By refocusing attention to political systems organized around and perpetuating inequitable health outcomes, nurses and other health care professionals—as well as those whom they serve—can concentrate their effort and power to act on political determinants of health in bringing about more equitable health outcomes. (shrink)

The nursing community in the United States polarized in September 2020 between Dawn Wooten's whistleblowing about forced hysterectomies at an immigration center in Georgia and the American Nurses Association's refusal to endorse a presidential candidate despite the Trump administration's mounting failures to address the public health crisis posed by the COVID-19 pandemic. This reveals a need for more attention to political aspects of health outcome inequities. As advocates for health equity, nurses can join in recent scholarship and activism concerning the (...) political determinants of health. In this paper, we examine recent work on the political determinants of health with an aim to add two things. First, we seek to build further on the notion of “political” determinants of health by distinguishing policy and governance structures from dynamics of politicization through appeal to critical disabilities studies. Second, we seek to apply this further nuanced approach to challenge rhetorical uses of “vulnerable populations,” where this phrase serves to misrecognize systemic institutionalized forces that actively exploit and marginalize people and groups. By refocusing attention to political systems organized around and perpetuating inequitable health outcomes, nurses and other health care professionals—as well as those whom they serve—can concentrate their effort and power to act on political determinants of health in bringing about more equitable health outcomes. (shrink)

Background The purpose of this systematic review is to examine cooling intervention research in outdoor occupations, evaluate the effectiveness of such interventions, and offer recommendations for future studies. This review focuses on outdoor occupational studies conducted at worksites or simulated occupational tasks in climatic chambers. -/- Methods This systematic review was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta‐Analysis (PRISMA) guidelines. PubMed, Embase, and Web of Science were searched to identify original research on intervention studies published (...) in peer‐reviewed journals that aimed at reducing heat stress or heat‐related illness from January 2000 to August 2020. -/- Results A systematic search yielded a total of 1042 articles, of which 21 met the inclusion criteria. Occupations with cooling intervention studies included agriculture (n = 5), construction (n = 5), industrial workers (n = 4), and firefighters (n = 7). The studies focused on multiple types of cooling interventions cooling gear (vest, bandanas, cooling shirts, or head‐cooling gel pack), enhanced heat dissipation clothing, forearm or lower body immersion in cold water, water dousing, ingestion of a crushed ice slush drink, electrolyte liquid hydration, and modified Occupational Safety and Health Administration recommendations of drinking water and resting in the shade. -/- Conclusion Current evidence indicates that using multiple cooling gears along with rest cycles may be the most effective method to reduce heat‐related illness. Occupational heat‐related illnesses and death may be mitigated by targeted cooling intervention and workplace controls among workers of vulnerable occupational groups and industries. (shrink)

For the past two decades, agricultural workers in regions of Central America have reported an epidemic of chronic kidney disease of undetermined etiology (CKDu) that is not associated with established risk factors of chronic kidney disease. Several hypotheses have emerged, but the etiology of CKDu remains elusive and controversial. The aim of this literature review was to describe the potential risk factors of CKDu in Mesoamerica and implications for the U.S. agricultural worker population. PubMed and CINAHL databases were searched for (...) articles published between 2000 and 2018 that examined CKDu in Mesoamerica; 29 original studies were included in this review. CKDu is a multifactorial disease that is often asymptomatic with hallmark characteristics of elevated serum creatinine and blood urea nitrogen (BUN), low glomerular filtration rate, electrolyte abnormalities, and non-nephrotic proteinuria. Reducing the global prevalence of CKDu will require more robust studies on causal mechanisms and on interventions that can reduce morbidity and mortality in vulnerable populations. (shrink)