Dataset Information

Estimating Occupational Illness, Injury, and Mortality in Food Production in the United States: A Farm-to-Table Analysis.

ABSTRACT: OBJECTIVES:The study provides a novel model and more comprehensive estimates of the burden of occupational morbidity and mortality in food-related industries, using a farm-to-table approach. METHODS:The authors analyzed 2008 to 2010 US Bureau of Labor Statistics data for private industries in the different stages of the farm-to-table model (production, processing, distribution and storage, and retail and preparation). RESULTS:The morbidity rate for food system industries was significantly higher than the morbidity rate for nonfood system industries (rate ratio = 1.62; 95% confidence interval = 1.30 to 2.01). Furthermore, the occupational mortality rate for food system industries was significantly higher than the national nonfood occupational mortality rate (rate ratio = 9.51; 95% confidence interval = 2.47 to 36.58). CONCLUSIONS:This is the first use of the farm-to-table model to assess occupational morbidity and mortality, and these findings highlighting specific workplace hazards across food system industries.

SUBMITTER: Newman KL

PROVIDER: S-EPMC4494896 | biostudies-literature | 2015 Jul

REPOSITORIES: biostudies-literature

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Estimating Occupational Illness, Injury, and Mortality in Food Production in the United States: A Farm-to-Table Analysis.

Newman Kira L KL Leon Juan S JS Newman Lee S LS

Journal of occupational and environmental medicine 20150701 7

<h4>Objectives</h4>The study provides a novel model and more comprehensive estimates of the burden of occupational morbidity and mortality in food-related industries, using a farm-to-table approach.<h4>Methods</h4>The authors analyzed 2008 to 2010 US Bureau of Labor Statistics data for private industries in the different stages of the farm-to-table model (production, processing, distribution and storage, and retail and preparation).<h4>Results</h4>The morbidity rate for food system industries wa ...[more]

PMID: 25970031

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Project description:BackgroundThis study used surveillance data from 2018 and 2020 to test the stability of work-related strain symptoms (high stress, sleep deprivation, exhaustion) with demographic factors, work characteristics, and musculoskeletal symptoms among farm and ranch operators in seven midwestern states of the United States.MethodsCross-sectional surveys were conducted among farm and ranch operators in 2018 (n = 4423) and 2020 (n = 3492). Operators were asked whether, in the past 12 months, they experienced extended work periods that resulted in high stress levels, sleep deprivation, exhaustion/fatigue, or other work-related strain symptoms. Covariates included personal and demographic factors, work characteristics, number of injuries, work-related health conditions, and exposures on the operation. Summary statistics were tabulated for explanatory and outcome variables. The classification (decision) tree approach was used to assess what variables would best separate operators with and without reported strain symptoms, based on a set of explanatory variables. Regularized regression was used to generate effect estimates between the work strain variables and explanatory variables.ResultsHigh stress level, sleep deprivation, and exhaustion were reported more frequently in 2018 than 2020. The classification tree reproduced the 2018 model using 2020 data with approximately 80% accuracy. The mean number of reported MSD symptoms increased slightly from 1.23 in 2018 to 1.41 in 2020. Older age, more time spent in farm work, higher gross farm income (GFI), and MSD symptoms in six body regions (ankles/feet, knees, lower back, neck, shoulders, wrists/hands) were associated with all three work strain symptoms.ConclusionsMusculoskeletal pain and discomfort was a strong predictor for stress, sleep deprivation, and exhaustion among farmers and ranchers. This finding indicates that reducing MSD pain and discomfort is beneficial for both physical and mental health.

Project description:ObjectivesWe investigated the association of healthy food retail presence and cardiovascular mortality, controlling for sociodemographic characteristics. This association could inform efforts to preserve or increase local supermarkets or produce market availability.DesignCohort study, combining Mortality Disparities in American Communities (individual-level data from 2008 American Community Survey linked to National Death Index records from 2008 to 2015) and retail establishment data.SettingAcross the continental US area-based sociodemographic and retail characteristics were linked to residential location by ZIP code tabulation area (ZCTA). Sensitivity analyses used census tracts instead, restricted to urbanicity or county-based strata, or accounted for non-independence using frailty models.Participants2 753 000 individuals age 25+ living in households with full kitchen facilities, excluding group quarters.Primary and secondary outcome measuresCardiovascular mortality (primary) and all-cause mortality (secondary).Results82% had healthy food retail (supermarket, produce market) within their ZCTA. Density of such retail was correlated with density of unhealthy food sources (eg, fast food, convenience store). Healthy food retail presence was not associated with reduced cardiovascular (HR: 1.03; 95% CI 1.00 to 1.07) or all-cause mortality (HR: 1.05; 95% CI 1.04 to 1.06) in fully adjusted models (with adjustment for gender, age, marital status, nativity, Black race, Hispanic ethnicity, educational attainment, income, median household income, population density, walkable destination density). The null finding for cardiovascular mortality was consistent across adjustment strategies including minimally adjusted models (individual demographics only), sensitivity analyses related to setting, and across gender or household type strata. However, unhealthy food retail presence was associated with elevated all-cause mortality (HR: 1.15; 95% CI 1.11 to 1.20).ConclusionsIn this study using food establishment locations within administrative areas across the USA, the hypothesised association of healthy food retail availability with reduced cardiovascular mortality was not supported; an association of unhealthy food retail presence with higher mortality was not specific to cardiovascular causes.

Project description:OBJECTIVE:Hospital-level variations in structure and process may affect clinical outcomes in ICUs. We sought to characterize the organizational structure, processes of care, use of protocols, and standardized outcomes in a large sample of U.S. ICUs. DESIGN:We surveyed 69 ICUs about organization, size, volume, staffing, processes of care, use of protocols, and annual ICU mortality. SETTING:ICUs participating in the United States Critical Illness and Injury Trials Group Critical Illness Outcomes Study. SUBJECTS:Sixty-nine intensivists completed the survey. MEASUREMENTS AND MAIN RESULTS:We characterized structure and process variables across ICUs, investigated relationships between these variables and annual ICU mortality, and adjusted for illness severity using Acute Physiology and Chronic Health Evaluation II. Ninety-four ICU directors were invited to participate in the study and 69 ICUs (73%) were enrolled, of which 25 (36%) were medical, 24 (35%) were surgical, and 20 (29%) were of mixed type, and 64 (93%) were located in teaching hospitals with a median number of five trainees per ICU. Average annual ICU mortality was 10.8%, average Acute Physiology and Chronic Health Evaluation II score was 19.3, 58% were closed units, and 41% had a 24-hour in-house intensivist. In multivariable linear regression adjusted for Acute Physiology and Chronic Health Evaluation II and multiple ICU structure and process factors, annual ICU mortality was lower in surgical ICUs than in medical ICUs (5.6% lower [95% CI, 2.4-8.8%]) or mixed ICUs (4.5% lower [95% CI, 0.4-8.7%]). We also found a lower annual ICU mortality among ICUs that had a daily plan of care review (5.8% lower [95% CI, 1.6-10.0%]) and a lower bed-to-nurse ratio (1.8% lower when the ratio decreased from 2:1 to 1.5:1 [95% CI, 0.25-3.4%]). In contrast, 24-hour intensivist coverage (p = 0.89) and closed ICU status (p = 0.16) were not associated with a lower annual ICU mortality. CONCLUSIONS:In a sample of 69 ICUs, a daily plan of care review and a lower bed-to-nurse ratio were both associated with a lower annual ICU mortality. In contrast to 24-hour intensivist staffing, improvement in team communication is a low-cost, process-targeted intervention strategy that may improve clinical outcomes in ICU patients.

Dataset Information

Estimating Occupational Illness, Injury, and Mortality in Food Production in the United States: A Farm-to-Table Analysis.

Publications

Estimating Occupational Illness, Injury, and Mortality in Food Production in the United States: A Farm-to-Table Analysis.

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