Thomas A Arcury

Wake Forest School of Medicine, Winston-Salem, North Carolina, United States

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Publications (405)752.31 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Little is known about how Latinos who live in the U.S. but who were born in Mexico and Central America (MCA) think and talk about key genetic concepts and the transmission of traits. Knowledge about gene-environment interaction may be particularly relevant to Latinos from MCA, as many are at risk of occupational and residential toxicant exposure. The objective of this analysis is to delineate the beliefs and knowledge that Latinos from MCA have about genetics, genomics, and the general transmission of traits from parents to children. In-depth, semi-structured interviews were conducted with 16 adult Latinos (8 mean and 8 women) living in North Carolina who were born in MCA. Interviews addressed participants’ beliefs and knowledge about transmission of traits and a few genetic terms. The interview guide did not assume that participants were familiar about basic genetic terms or concepts. Interview transcripts were systematically analyzed using qualitative software.The concept of “blood” was central to many participants’ discussions about transmission of traits, including physical traits and shared illnesses. “Blood” was understood metaphorically by some, literally by others. Participants indicated that children receive traits from the parent who has “stronger” blood. Many participants had difficulty articulating what genes are and how they are involved in the transmission of traits. Some participants integrated accurate knowledge about the transmission of traits with unique beliefs. Culturally and linguistically appropriate educational programs may enable Latinos to understand advances in genetics and genomics and use that knowledge to improve health behavior and make informed health decisions.
    142nd APHA Annual Meeting and Exposition 2014; 11/2014
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    ABSTRACT: Housing quality and neighborhood characteristics affect individual health and family well-being. This analysis describes characteristics of farmworker housing and neighborhoods and delineates the associations of housing and local neighborhood with indicators of family well-being. Mothers in North Carolina farmworker families (n = 248) completed interviews in 2011-2012. Family well-being measures included stress, family conflict, and outward orientation. Housing measures included ownership and facilities, and neighborhood measures included heavy traffic and driving time to grocery stores. Families experienced elevated stress and conflict, and limited outward orientation. Few owned their homes, which were generally crowded. Few had enclosed play spaces for their children. For many, traffic made it difficult to walk on the street. Housing and neighborhood characteristics were related to increased stress and limited outward orientation. Housing and neighborhood characteristics are important for research on the health of families in vulnerable populations, such as farmworker families.
    Journal of Immigrant and Minority Health 11/2014; 17(5). DOI:10.1007/s10903-014-0126-4 · 1.16 Impact Factor
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    ABSTRACT: Aims To evaluate the demographic and health correlates of reporting diabetes symptoms, and the relationship between diabetes symptoms and self-management behaviors in rural older adults. Methods Cross-sectional interviews were conducted with 489 African American, American Indian, and white female and male adults 60 years and older. Participants with diabetes were recruited from eight North Carolina counties. Participants completed the 34-item Diabetes Symptom Checklist (DSC). Associations of demographic and health characteristics with reported symptoms were evaluated. Multivariate linear regression models were used to examine the associations of DSC scores and diabetes self-management. Results Participants had low scores on the DSC. They largely practices appropriate diabetes self-management behaviors (self-foot checks, fruit and vegetable consumption, and self-monitoring blood glucose). Correlates of DSC included women having higher scores for hypoglycemia, psychological total, and fatigue dimensions. Neuropathic pain and vision dimensions were significantly associated with educational attainment. Most DSC dimensions were associated with ethnicity or economic status. Taking oral diabetes medicine was correlated with hyperglycemia; insulin use was associated with most DSC dimensions. HbA1c was not associated with any DSC dimension; diabetes duration >10 years was correlated with all dimensions except neuropathic pain and vision. Higher levels of psychological fatigue were significantly associated with fewer self-management behaviors. Discussion/Conclusions Demographic and health characteristics are associated with reported symptoms. Fatigue is a symptom negatively associated with diabetes self-management behavior in older adults. Health care providers are uniquely positioned to assess patient symptoms and potential relationships with successful diabetes management.
    Diabetes Research and Clinical Practice 10/2014; 107(1). DOI:10.1016/j.diabres.2014.10.005 · 2.54 Impact Factor
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    ABSTRACT: ABSTRACT Farm labor housing has been described as among the worst in the nation, oftentimes with poor and unsanitary indoor living conditions. The objective of this study was to evaluate the association between indoor environmental risk factors and respiratory health among migrant farmworker occupants (N = 352) living in employer-provided housing. A cross-sectional sample of adult Latino male farm laborers were administered a questionnaire to identify the prevalence of major respiratory symptoms. Self-reported and independent observations were made to evaluate environmental respiratory risk factors and indoor housing conditions, including but not limited to, the presence of cockroaches, rodents, pesticides, and visible signs of mold. Spirometry was performed to evaluate lung function using FEV1 (forced expiratory volume in 1 second), FVC (forced vital capacity), and FEV1 /FVC ratio. Bivariate analysis was applied to evaluate associations between respiratory symptoms and selected indoor environmental risk factors. Findings for respiratory health included prevalence of wheeze (11.4%), coughing up phlegm (17.3%), tightness of chest (16.8%), and runny or stuffy nose (34.4%). Respiratory risks identified inside the dwellings included the use of pesticides or bug sprays for cockroaches (31.5%), rat or mouse poison (19.5%), visible signs of water damage in the bathroom (22.5%), and mold in the sleeping room (11.1%). Spirometry values were normal for most occupants, although statistically significant associations were found between mold and coughing up phlegm when not having a cold (P = .0262); presence of mold and asthma (P = .0084); pesticides used in the home and tightness of chest (P = .0001); and use of tobacco and coughing up phlegm (P = .0131). Although causal inference can be difficult to establish from a cross-sectional study, findings from this study represents suggestive evidence that indoor environmental risk factors may be contributory factors for respiratory health problems among this vulnerable workgroup population.
    Journal of Agromedicine 10/2014; 19(4):395-405. DOI:10.1080/1059924X.2014.947458 · 0.91 Impact Factor
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    ABSTRACT: ABSTRACT Agriculture is a unique US industry in how youth are involved. Youth employed in agriculture experience high rates of injury, and youth migrant and seasonal farmworkers may be extremely vulnerable. The primary aim for this analysis is to describe the personal characteristics, work characteristics, occupational safety behaviors, and occupational injuries of North Carolina youth farmworkers. This pilot study uses data from interviewer-administered questionnaires with 87 youth farmworkers. Participants included males (62.1%) and females (37.9%), with 26.4% aged 10-13 years, 39.1% 14-15 years, and 34.5% 16-17 years. The majority (78.2%) were born in the United States. Most worked in tobacco (46.0%), sweet potatoes (28.7%), and berries (28.7%). They were paid by the hour (54.0%) and piece rate (55.2%); 21.8% reported a problem getting paid the amount earned. Three quarters wore a hat, and 63.2% wore gloves while working. Five (5.7%) had received pesticide use training in the past year. Over half reported a musculoskeletal injury (54.0%), a traumatic injury (60.9%), or a dermatological injury (72.4%) in the last year. Six of the injuries led to medical treatment, and 10 resulted in missed school or work. Farmworker youth in North Carolina are at times not treated fairly when they work, occupational safety behaviors are limited (increasing exposure to pesticides and other environmental hazards), and they commonly experience injuries. Research on the occupational exposures and health experienced by youth farmworkers is needed to inform policy. Changes in policy are warranted to improve the safety of youth farmworkers.
    Journal of Agromedicine 10/2014; 19(4):354-363. DOI:10.1080/1059924X.2014.945712 · 0.91 Impact Factor
  • Daryl A Rosenbaum · Dana C Mora · Thomas A Arcury · Haiying Chen · Sara A Quandt ·
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    ABSTRACT: ABSTRACT Between-employer differences in working conditions may lead to variable injury rates. The objective of this paper is to assess the difference in the prevalence of epicondylitis, rotator cuff syndrome, and low back pain among immigrant Latino poultry workers at plants of three different employers. Data were collected from a cross-sectional study among 286 poultry processing workers. Community-based sampling was used to recruit participants in western North Carolina. Rotator cuff syndrome (26.7%) and low back pain (27.9%) were more prevalent among employees of one specific employer. Multivariate analysis showed significant associations of low back pain and rotator cuff syndrome with age, task performed in the processing line, and employer. Employer is a major predictor of musculoskeletal disorders and pain. Line speed and work pace may account for these differences and provide an opportunity for regulation and intervention to protect the health of workers.
    Journal of Agromedicine 10/2014; 19(4):384-394. DOI:10.1080/1059924X.2014.945710 · 0.91 Impact Factor
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    ABSTRACT: Introduction: The aim of this study was to determine whether there is an association between flexor digitorum and lumbrical muscle intrusion into the carpal tunnel and carpal tunnel syndrome (CTS). Methods: Five hundred thirteen manual laborers (1026 wrists) were evaluated with ultrasound to determine whether those with CTS had more muscle intrusion into the carpal tunnel than those without CTS. One hundred ninety of the participants without CTS at baseline (363 wrists) were followed over 1 year to determine whether muscle intrusion at baseline predicted the development of CTS. Results: Participants with CTS had more muscle within the carpal tunnel with the wrist in the neutral (P=0.026) and flexed (P=0.018) positions than those without CTS. Baseline muscle intrusion did not predict development of CTS at 1 year. Conclusions: Muscle intrusion into the carpal tunnel is associated with CTS, but muscle intrusion alone does not predict the development of CTS over the course of a year.
    Muscle & Nerve 10/2014; 50(4). DOI:10.1002/mus.24183 · 2.28 Impact Factor
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    ABSTRACT: A substantial number of Latino farmworkers migrate to the U.S. from Mexico and other Central American countries, many of whom are fathers. This study investigated migrant Latino farmworkers' fathering behaviors, father involvement correlates, and family relationship variables. We analyzed structured interview data from primarily Mexican migrant farmworker fathers (N=192) in North Carolina. Father child phone contact, coparenting cooperation, and relationship quality with children's mothers were interrelated and positively correlated with fathers' closeness to their children. Pre-migration father engagement was negatively correlated with fathers' reported closeness to their children following migration. A positive migration outlook among fathers seemed to connect with more cooperative coparenting and less depressive symptomology. Our fmdings suggest migration for migrant farmwork may still afford men close family relationships given cultural values emphasizing the importance of fathers' financial provision to their family members.
    Journal of comparative family studies 09/2014; 45(4):537-557. · 0.48 Impact Factor
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    ABSTRACT: ABSTRACT This analysis uses a longitudinal design to examine the associations of work organization and health outcomes among Latino manual workers. Participants included 247 Latino workers who completed baseline and one-year follow-up interviews and clinical exams. Health outcome measures were epicondylitis, rotator cuff syndrome, back pain, and depressive symptoms. Independent measures were measures of job demand, job control, and job support. Workers commonly experienced rotator cuff syndrome (6.5%), back pain (8.9%), and depressive symptoms (11.2%); fewer experienced epicondylitis (2.4%). Psychological demand was associated with rotator cuff syndrome; awkward position and decision latitude were associated with back pain. Decreased skill variety but increased decision latitude was associated with elevated depressive symptoms. Work context factors are important for health outcomes among vulnerable workers. Further research is needed to expand upon this work, particularly cultural perspectives on job support.
    Archives of Environmental and Occupational Health 08/2014; DOI:10.1080/19338244.2014.955164 · 0.93 Impact Factor
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    ABSTRACT: Background Pesticide exposure poses a health risk for farmworkers. This analysis documents lifetime and current pesticide exposure of North Carolina Latino migrant farmworkers, with comparison to non-farmworker Latino immigrants.Methods During May to October 2012, 235 Latino farmworkers and 212 Latino non-farmworkers completed interviews with items to construct measures of lifetime, current residential and occupational pesticide exposure.ResultsFarmworkers experience levels of lifetime and residential pesticide exposure that are consistently greater than among non-farmworkers. Farmworkers report a large number of occupational pesticide exposures. Lifetime exposure and current residential pesticide exposure are related to social determinants. Education is inversely related to lifetime pesticide exposure for farmworkers and non-farmworkers; farmworkers with H-2A visas report greater residential pesticide exposure than those without H-2A visas.Conclusions Occupational safety policy needs to consider these patterns of lifetime exposure when setting standards. Health care providers should be aware of the lifetime and current exposure of this vulnerable population. Am. J. Ind. Med. © 2014 Wiley Periodicals, Inc.
    American Journal of Industrial Medicine 07/2014; 57(7). DOI:10.1002/ajim.22324 · 1.74 Impact Factor
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    ABSTRACT: This analysis describes beliefs about work safety and personal protective equipment (PPE) among Latino roofing workers, it delineates their perceptions of work environment characteristics that affect work safety and PPE use, and it describes how they experience work injuries and the consequences of these injuries. In-depth interviews were completed with 10 current and former Latino residential roofers. Interview transcripts were subjected to systematic qualitative analysis. Participants' valued productivity over safety, and this had a negative influence on their safety behavior and reduced their PPE use. They understood that roofing was hazardous. They limited use of PPE when they felt it reduced productivity and when it was uncomfortable. Work environment characteristics that affected safety included company size, the physical demands of the job, lack of training, the need for work, general life stress, and distractions at work. An injury had to result in lost work time to be considered significant. Access to health care is limited by employers not providing Workers' compensation. Future research is needed to substantiate these descriptive results and to delineate factors that are associated with safety behavior and use of PPE. Interventions, based on a lay health educator model, are needed to improve safety in this population. Safety regulations need to be evaluated and their enforcement needs to be improved. Am. J. Ind. Med. © 2013 Wiley Periodicals, Inc.
    American Journal of Industrial Medicine 06/2014; 57(6). DOI:10.1002/ajim.22248 · 1.74 Impact Factor
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    ABSTRACT: Objectives: This study describes the nonprescribed therapy use (prayer, over-the-counter medications [OTC's], home remedies, vitamins, herbs and supplements, and exercise) for health promotion among rural elders. It also delineates the association of such therapy use with physical and mental health-related quality of life (HRQoL). Method: The sample (N = 200) consisted of African American and White elders from south-central North Carolina. Participants completed baseline interviews and repeated measures of nonprescribed therapy use over a 6-month follow-up. Results: Prayer had the highest percentage (80.7%) of use for health promotion followed by OTC (54.3%); vitamins only (49.3%); herbs and supplements (40.5%); exercise (31.9%); and home remedies (5.2%). Exercise was significantly associated with better physical HRQoL (p < .05). However, elders who used nonprescribed therapies had poorer mental HRQoL than nonusers, adjusting for potential confounders. Conclusion: This analysis suggests that use of some nonprescribed therapies for health promotion is associated with poorer mental HRQoL.
    06/2014; 33(4):456-473. DOI:10.1177/0733464812453518
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    ABSTRACT: Objectives: Latino immigrant workers experience elevated rates of skin disease that result from their working and living conditions. Working in manual occupations exposes workers to a variety of challenges, including occlusive shoes, vigorous physical activity, and wet conditions. These challenges predispose workers to fungal infection. The objectives of this article are to examine the comorbidity of tinea pedis and onychomycosis and to identify possible risk factors among Latino immigrant poultry and nonpoultry workers in western North Carolina. Methods: Data were obtained from a cross-sectional study conducted between June 2009 and November 2010 in rural western North Carolina among 518 manual Latino immigrant workers to assess their occupational injuries. Participants completed a face-to-face interview and a dermatologic examination. Results: Nearly one-third of the participants (32%) were diagnosed as having onychomycosis and more than one-third (37.8%) were diagnosed as having tinea pedis. There was a greater prevalence of tinea pedis in men than women (71.3% vs 28.7%, respectively). Of the 518 participants, 121 (23.5%) had both conditions. Participants who reported the use of occlusive shoes as "always" or "most of the time" had a higher prevalence of comorbid onychomycosis and tinea pedis than the rest of the group. Conclusions: Comorbidity of tinea pedis and onychomycosis is common among immigrant Latino men and women who perform manual labor. Further studies confirming the presence and type of dermatophyte should be conducted.
    Southern Medical Journal 06/2014; 107(6):374-379. DOI:10.14423/01.SMJ.0000450705.67259.26 · 0.93 Impact Factor
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    ABSTRACT: Objective: To describe time spent in sedentary and moderate-to-vigorous physical activity (MVPA) by children in Latino farmworker families and delineate sources of variation in sedentary and MVPA. Method: Data were from mother-child dyads (N = 248) in Latino farmworker households in North Carolina. Physical activity was assessed using accelerometers; mothers described their children's characteristics and their physical and social environments. Results: Children spent 6.2 hours/day sedentary (Median=369 minutes), and 6.0 minutes/day in MVPA. Children in Head Start spent more time sedentary, whereas children living where dogs roam freely were less sedentary. Children whose mothers limited screen time spent 2 more minutes in MVPA. Conclusions: Preschool-aged Latino children in farmworker families are sedentary, engaging in little MVPA.
    American journal of health behavior 06/2014; 38(5):717-725. DOI:10.5993/AJHB.38.5.9 · 1.31 Impact Factor
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    ABSTRACT: Manual labor employment occurs in environments with exposures likely to impact skin-related quality of life (SRQOL). The objectives of this paper are to (1) document the dimensions of SRQOL, (2) examine its association with skin symptoms, and (3) identify the predictors of SRQOL in Latino manual workers. A population-based survey of 733 Latino manual workers obtained Dermatology Life Quality Index (DLQI) and skin symptoms in the prior year. Two-thirds of workers were employed in production. Skin symptoms in prior year were reported by 23%. Impaired SRQOL was reported by 23%. In multivariate analyses, reduced SRQOL was associated with age, occupation, childhood indigenous language use, and experience of skin symptoms in the prior year. Despite overall high SRQOL exposures in some immigrant occupational groups produce reduce SRQOL. This rural, immigrant population faces significant obstacles to obtaining dermatological care; efforts are needed to improve their SRQOL. Am. J. Ind. Med. 9999:1-10, 2013.© 2013 Wiley Periodicals, Inc.
    American Journal of Industrial Medicine 05/2014; 57(5). DOI:10.1002/ajim.22291 · 1.74 Impact Factor
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    ABSTRACT: This analysis examines the associations of work organization attributes among Latino women in manual occupations with musculoskeletal and neurological injuries. Participants included 234 women in western North Carolina. Outcome measures included epicondylitis, rotator cuff syndrome, back pain, and carpal tunnel syndrome. Independent measures included indicators of job demand, job control, and job support, as well as personal characteristics. Latina workers commonly experienced epicondylitis, rotator cuff syndrome, back pain, and CTS. Awkward posture and decision latitude were associated with epicondylitis. Rotator cuff syndrome was associated with awkward posture and psychological demand. Awkward posture and psychological demand, and decreased skill variety and job control were related to CTS. Work organization factors are potentially important for musculoskeletal and neurological injury among vulnerable workers. Research is required to understand the associations of work and health outcomes of these women. Policy initiatives need to consider how work organization affects health. Am. J. Ind. Med. 9999:1-8, 2014. © 2014 Wiley Periodicals, Inc.
    American Journal of Industrial Medicine 04/2014; 57(4). DOI:10.1002/ajim.22298 · 1.74 Impact Factor
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    ABSTRACT: This study examined the use of self-care strategies to address difficulty sleeping among community-dwelling older adults. Data were collected from a series of 18 questionnaires administered to 195 rural African American and white older adults in North Carolina. Participants reported whether they had experienced difficulty sleeping and strategies used to respond to the symptom. The most widely used strategies included ignoring the symptom, staying in bed or resting, and praying. Herb and supplement use were not reported. Ethnicity, income, and education were associated with use of specific self-care strategies for sleep. This variation suggests that older adults may draw on cultural understandings to interpret the significance of difficulty sleeping and influence their use of self-care strategies, including complementary and alternative medicine use. This information may enable health care providers to communicate with the older patients about sleep difficulty strategies to minimize sleep problems.
    03/2014; 19(1):36-42. DOI:10.1177/2156587213510005
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    ABSTRACT: Objectives: We sought to identify coherent profiles of diabetes beliefs within discrete domains (ie causes, symptoms, consequences, self management, and medical management), and delineate consistency of belief profiles over one month. Methods: Diabetes beliefs of rural-dwelling older adults were assessed with the Common Sense Model of Diabetes Inventory at baseline (N = 593) and one month later (N = 563). Results: A discrete number of belief patterns were identified in each belief domain using latent class analysis. Belief patterns varied by the extent to which more popular or folk notions of diabetes encroached on biomedical understandings of the disease. Belief patterns were generally stable over time. Conclusions: A manageable number of belief patterns can be identified and used to strengthen patient-centered care and, potentially, enhance diabetes management.
    03/2014; 1(2). DOI:10.14485/HBPR.1.2.3
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    ABSTRACT: The purpose of this paper is to present and evaluate descriptively bivariate associations between urinary metabolites of pesticides and herbicides and migrant camp conditions, violations, and personal worker behaviors at home for farmworkers who do not apply pesticides. We studied 183 migrant farmworker camps in eastern North Carolina in 2010. Data and urine samples were collected from 371 men. Predictor measures included violations in six domains of housing regulations and nonviolation characteristics and personal behaviors that might impact urinary metabolites. Cockroaches and bathroom violations were predictive of increased exposure to pyrethroids and cyfluthrin/chlorpyrifos, respectively. Changing and storing clothing and shoes in sleeping rooms increased the number of detects for the diazinon metabolite. Farmworkers had exposures to multiple chemicals. No single housing domain was identified as critical to mitigating housing-related exposure; specific attention should be paid to changing and storing soiled clothing in sleeping rooms, and insect infestations. Am. J. Ind. Med. © 2013 Wiley Periodicals, Inc.
    American Journal of Industrial Medicine 03/2014; 57(3). DOI:10.1002/ajim.22284 · 1.74 Impact Factor
  • Thomas A Arcury · Chensheng Lu · Haiying Chen · Sara A Quandt ·
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    ABSTRACT: Migrant farmworkers are exposed to pesticides at work. Housing provided to migrant farmworkers may also expose them to pesticides, increasing their health risks. This analysis (1) describes the presence of organophosphorous (OP) and pyrethroid pesticides in North Carolina migrant farmworker houses, and (2) delineates associations of farmworker camp characteristics with pesticide detection and concentration. In 2010, 186 migrant farmworkers camps in NC were recruited (participation rate of 82.3%); pesticide wipe samples for 176 houses were analyzed. Tobacco is the predominant hand-harvested crop in this region. Two farmworkers per camp completed interviews; a third assisted with a housing inspection. Gas chromatography-mass spectrometry was used to detect OP and pyrethroid pesticides. Covariates of pesticide detection and concentration were determined with ANOVA and Tobit regression. OPs were found in 166 of 176 houses (average of 2.4/house); pyrethroids were found in 171 houses (average of 4.3/house). The number of different OPs detected in each camp and concentrations of these OPs were not associated with camp and housing characteristics. The number of different pyrethroids detected in each camp and concentrations of these pyrethroids were associated with camps having residents with H2-A visas, a posted North Carolina Department of Labor Certificate of Inspection, no barracks, fewer residents, no bedroom weather protection or floor violations, and no roaches. Farmworkers are exposed to pesticides where they live. Policy on removing pesticides from farmworker houses is needed. Reducing pesticides in farmworker houses will reduce one health risk confronted by this vulnerable population. Am. J. Ind. Med. © 2013 Wiley Periodicals, Inc.
    American Journal of Industrial Medicine 03/2014; 57(3). DOI:10.1002/ajim.22232 · 1.74 Impact Factor

Publication Stats

7k Citations
752.31 Total Impact Points


  • 1970-2015
    • Wake Forest School of Medicine
      • • Center for Worker Health
      • • Department of Family and Community Medicine
      • • Department of Dermatology
      Winston-Salem, North Carolina, United States
  • 2000-2013
    • Wake Forest University
      • • Department of Internal Medicine
      • • Department of Sociology
      • • Department of Family and Community Medicine
      Winston-Salem, North Carolina, United States
  • 2011
    • Guilford College
      Greensboro, North Carolina, United States
  • 2008-2009
    • University of North Carolina at Greensboro
      • Department of Public Health Education
      Greensboro, North Carolina, United States
  • 1996-2008
    • University of North Carolina at Chapel Hill
      • • Cecil G. Sheps Center for Health Services Research
      • • Department of Biostatistics
      • • Center for Urban and Regional Studies
      North Carolina, United States
  • 2006
    • University of Toledo
      Toledo, Ohio, United States