Barbara Marlenga

Queens University of Charlotte, New York, United States

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Publications (46)81.32 Total impact

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    ABSTRACT: This study examined self-perceived health status among men and women who live on farms, as well as variations in factors related to negative health status observed by gender. Data were collected in the province of Saskatchewan, Canada, in 2013 through the use of a cross-sectional survey. A multistage sample was developed consisting of farms nested within rural municipalities and then agricultural soil zones. The response rate was 48.8% at the farm level, with a final sample of 2,353 (1,416 men, 937 women) from 1,119 farms. Variables under study included self-reports of health status, as well as demographic, behavioral, and farm operational factors that could influence perceived health status. The analysis was initially descriptive followed by multilevel logistic regression analyses. Self-reports of diagnosed comorbidities were strongly associated with negative health status among both men and women. Daytime sleepiness was more modestly associated with negative health status in both genders. Among men, additional risk factors tended to be functional, and included older age, part-time work status, and binge drinking. Among women, additional risk factors included cigarette smoking, overweight or obesity, and lower levels of education. The study demonstrated that there were both similarities and differences between men and women on farms in the factors related to negative self-perceived health status. These findings should inform the content and targeting of health promotion programs aimed at rural populations.
    Journal of Agromedicine 04/2015; 20(2):178-187. DOI:10.1080/1059924X.2015.1010063 · 0.91 Impact Factor

  • Journal of Agromedicine 06/2014; 19(2):211-212. DOI:10.1080/1059924X.2014.891481 · 0.91 Impact Factor
  • David Hard · David C Schwebel · Tammy Ellis · Barbara Marlenga ·

    Journal of Agromedicine 06/2014; 19(2):214. DOI:10.1080/1059924X.2014.891474 · 0.91 Impact Factor
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    ABSTRACT: Competing theories exist about why asymmetry is observed in noise-induced hearing loss (NIHL). We evaluated these theories using a cohort of young workers studied over 16 years. The study aim was to describe and evaluate patterns of hearing loss and asymmetry by gender, agricultural exposure and gunfire exposure. This was a secondary analysis of data collected from young adults during follow-up of a randomized controlled trial. This follow-up study evaluated long-term effects of a hearing conservation intervention for rural students. The sample consisted of 392 of 690 participants from the original trial. In total, 355 young adults (aged 29-33 years) completed baseline and follow-up noise exposure surveys and clinical audiometric examinations. Data are displayed graphically as thresholds by frequency and ear and degree of asymmetry between ears (left minus right). In the primary group comparisons, low and high frequency averages and mean high frequency asymmetry were analyzed using mixed linear models. At frequencies >2000 Hz, men showed more hearing loss, with greater asymmetry and a different asymmetry pattern, than women. For men with documented hearing loss, there was a trend toward increasing asymmetry with increasing levels of hearing loss. Asymmetry at high frequencies varied substantially by level of shooting exposure. While "head shadowing" is accepted as the primary explanation for asymmetric hearing loss in the audiologic and related public health literature, our findings are more consistent with physiological differences as the primary cause of asymmetric hearing loss, with greater susceptibility to NIHL in the left ear of men.
    Noise and Health 03/2014; 16(69):102-107. DOI:10.4103/1463-1741.132092 · 1.48 Impact Factor
  • Suzanne Wright · Barbara Marlenga · Barbara C Lee ·
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    ABSTRACT: Every three days a child dies in an agriculture-related incident, and every day 45 children are injured in the United States. These tragedies should not be regarded as "accidents," as they often follow predictable and preventable patterns. Prevention is not only possible, but vital, since many of these injuries are almost immediately fatal. Major sources of fatal injuries are machinery, motor vehicles, and drowning. Tractor injuries alone account for one-third of all deaths. The leading sources of nonfatal injuries are structures and surfaces, animals (primarily horses), and vehicles (primarily all-terrain vehicles [ATVs]). Children living on farms are at a higher risk than hired workers, and are unprotected by child labor laws. Preschool children and older male youth are at the highest risk for fatal injury, while nonfatal injury was most common among boys aged 10-15 years. Multiple prevention strategies have been developed, yet economic and cultural barriers often impede their implementation. Educational campaigns alone are often ineffective, and must be coupled with re-engineering of machines and safety devices to reduce fatalities. Legislation has the potential to improve child safety, yet political and economic pressures often prohibit changes in child labor laws and mandated safety requirements. Clinicians play a pivotal role in injury prevention, and should actively address common rural risk-taking behaviors as part of the routine office visit in order to help prevent these tragedies.
    Current problems in pediatric and adolescent health care 02/2013; 43(2):20-44. DOI:10.1016/j.cppeds.2012.08.002 · 1.63 Impact Factor
  • B. Lee · S. Gallagher · A. Liebman · M. Miller · B. Marlenga ·

    Injury Prevention 10/2012; 18(Supplement 1):A101-A101. DOI:10.1136/injuryprev-2012-040590d.15 · 1.89 Impact Factor
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    ABSTRACT: In 1996 the US launched a National Childhood Agricultural Injury Prevention Initiative, guided by an action plan generated by a 42-member multidisciplinary committee. A major update to the plan was released following the 2001 Summit on Childhood Agricultural Injury Prevention. From the year 2010 through 2011 a comprehensive assessment of progress to date was conducted followed by the drafting, review and finalizing of a new action plan-"The 2012 Blueprint for Protecting Children in Agriculture." This paper briefly describes the purpose and process for generating the new action plan then provides a listing of the 7 goals and 26 strategies within the plan. These goals and strategies account for trends in childhood agricultural injuries, changes in agricultural production and the demographics of its workforce, effectiveness of interventions, and the increasing use of social media, marketing and social networking. Primary funding for this project was provided by the National Institute for Occupational Safety and Health (NIOSH), which continues to serve as the lead federal agency for the national initiative.
    Journal of Agromedicine 04/2012; 17(2):88-93. DOI:10.1080/1059924X.2012.660437 · 0.91 Impact Factor
  • Barbara Marlenga · Barbara C Lee · William Pickett ·
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    ABSTRACT: The North American Guidelines for Children's Agricultural Tasks (NAGCAT) were developed to assist parents in assigning developmentally appropriate and safe farm work to their children aged 7-16 years. Since their release in 1999, a growing body of evidence has accumulated regarding the content and application of these guidelines to populations of working children on farms. The purpose of this paper is to review the scientific and programmatic evidence about the content, efficacy, application, and uptake of NAGCAT and propose key recommendations for the future. The methods for this review included a synthesis of the peer-reviewed literature and programmatic evidence gathered from safety professionals. From the review, it is clear that the NAGCAT tractor guidelines and the manual material handling guidelines need to be updated based upon the latest empirical evidence. While NAGCAT do have the potential to prevent serious injuries to working children in the correct age range (7-16 years), the highest incidence of farm related injuries and fatalities occur to children aged 1-6 years and NAGCAT are unlikely to have any direct effect on this leading injury problem. It is also clear that NAGCAT, as a voluntary educational strategy, is not sufficient by itself to protect children working on farms. Uptake of NAGCAT has been sporadic, despite being geographically widespread and has depended, almost solely, on a few interested and committed professionals. Key recommendations for the future are provided based upon this review.
    Journal of Agromedicine 04/2012; 17(2):140-8. DOI:10.1080/1059924X.2012.661305 · 0.91 Impact Factor
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    ABSTRACT: The authors had a unique opportunity to study the early impacts of occupational and recreational exposures on the development of noise-induced hearing loss (NIHL) in a cohort of 392 young workers. The objectives of this study were to estimate strength of associations between occupational and recreational exposures and occurrence of early-stage NIHL and to determine the extent to which relationships between specific noise exposures and early-stage NIHL were mitigated through the use of hearing protection. Participants were young adults who agreed to participate in a follow-up of a randomised controlled trial. While the follow-up study was designed to observe long-term effects (up to 16 years) of a hearing conservation intervention for high school students, it also provided opportunity to study the potential aetiology of NIHL in this worker cohort. Study data were collected via exposure history questionnaires and clinical audiometric examinations. Over the 16-year study period, the authors documented changes to hearing acuity that exceeded 15 dB at high frequencies in 42.8% of men and 27.7% of women. Analyses of risk factors for NIHL were limited to men, who comprised 68% of the cohort, and showed that risks increased in association with higher levels of the most common recreational and occupational noise sources, as well as chemical exposures with ototoxic potential. Use of hearing protection and other safety measures, although not universal and sometimes modest, appeared to offer some protection. Early-stage NIHL can be detected in young workers by measuring high-frequency changes in hearing acuity. Hearing conservation programmes should focus on a broader range of exposures, whether in occupational or non-occupational settings. Priority exposures include gunshots, chainsaws, power tools, smoking and potentially some chemical exposures.
    Occupational and environmental medicine 03/2012; 69(7):479-84. DOI:10.1136/oemed-2011-100464 · 3.27 Impact Factor
  • Mary E. Miller · Art Kerschner Jr · Barbara Marlenga ·
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    ABSTRACT: Background and Objective The agricultural child labor regulations are promulgated under the Fair Labor Standards Act (FLSA) and administered and enforced by the U.S. Department of Labor's Wage and Hour Division. Many states also have their own regulations which in some cases exceed the federal rules, such as Washington State. Following recommendations by the National Institute for Occupational Safety and Health (NIOSH) and additional extensive analyses, the Wage and Hour Division proposed the first substantive update of the federal child labor laws that regulate hazardous work activities in agriculture since 1970. The objective of this session is to review the historical underpinnings of the regulated activities for children working in agriculture and the differences in protection for youth working in similarly hazardous work activities in non-agricultural jobs. Methods A review of the background of key legislative and regulatory milestones of the initial laws limiting hazardous work by children in agriculture, to the more recent developments contributing to the current revisions will be presented. The significant differences between agricultural and non-agricultural regulations will be highlighted. Results Strengths and limitations of the protections under the agricultural regulations will be summarized and recommendations for further action will be discussed. Despite new updates, groups of children remain outside of the protections of federal regulations. A review of these exemptions will be included. Conclusion The range of strategies necessary to protect children from dangerous activities, including political; regulatory and enforcement; and outreach and education strategies are needed and will be summarized.
    139st APHA Annual Meeting and Exposition 2011; 11/2011
  • Barbara Marlenga · Barbara C. Lee · William Pickett ·
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    ABSTRACT: Background and Objectives: The North American Guidelines for Children's Agricultural Tasks (NAGCAT) are a safety resource to assist farm parents in assigning developmentally appropriate work for their children aged 7-16 years. NAGCAT were released in 1999 and since that time a growing body of scientific evidence has accumulated. This paper will assess programmatic and scientific evidence regarding NAGCAT and provide recommendations for research, policy, and programs for the next 10 years. Methods: Programmatic evidence is being gathered from agricultural safety practitioners and a comprehensive synthesis of the peer-reviewed literature is being conducted. Results: The NAGCAT resource has been used and modified in the U.S., Canada, Scandinavia, Australia, and the Philippines. More recently, at the request of agricultural employers, a version of NAGCAT were produced that included U.S. child labor regulations and employers' responsibilities. Research results reveal parents' use of NAGCAT improves if dissemination is accompanied by a farm visit from a safety specialist or if child development principles are provided along with the guidelines. In a review of injury cases, 70% to 80% of the most serious work-related injuries could have been prevented if NAGCAT had been applied. Anthropometric and ergonomic analyses of children's physical ability to operate tractors provide empirical evidence to support a higher age limit for tractor operations, higher than the ages currently recommended in NAGCAT. Conclusion: Future priorities include the need to update the tractor operations guidelines in order to optimize the potential effectiveness of NAGCAT for preventing agricultural work-related injuries to children.
    139st APHA Annual Meeting and Exposition 2011; 11/2011
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    ABSTRACT: We had the rare opportunity to conduct a cluster-randomized controlled trial to observe the long-term (16-year) effects of a well-designed hearing conservation intervention for rural high school students. This trial assessed whether the intervention resulted in (1) reduced prevalence of noise-induced hearing loss (NIHL) assessed clinically and/or (2) sustained use of hearing protection devices. In 1992-1996, 34 rural Wisconsin schools were recruited and 17 were assigned randomly to receive a comprehensive, 3-year, hearing conservation intervention. In 2009-2010, extensive efforts were made to find and contact all students who completed the original trial. Participants in the 16-year follow-up study completed an exposure history questionnaire and a clinical audiometric examination. Rates of NIHL and use of hearing protection were compared. We recruited 392 participants from the original trial, 200 (53%) from the intervention group and 192 (51%) from the control group. Among participants with exposure to agricultural noise, the intervention group reported significantly greater use of hearing protection compared with the control group (25.9% vs 19.6%; P = .015). The intervention group also reported significantly greater use of hearing protection for shooting guns (56.2% vs 41.6%; P = .029), but the groups reported similar uses of protection in other contexts. There was no significant difference between groups with respect to objective measures of NIHL. This novel trial provides objective evidence that a comprehensive educational intervention by itself may be of limited effectiveness in preventing NIHL in a young rural population.
    PEDIATRICS 11/2011; 128(5):e1139-46. DOI:10.1542/peds.2011-0770 · 5.47 Impact Factor
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    ABSTRACT: To estimate the strength of relationships between socioeconomic status and injury in a large Canadian farm population. We conducted a prospective cohort study of 4,769 people from 2,043 farms in Saskatchewan, Canada. Participants reported socioeconomic exposures in 2007 and were followed for the occurrence of injury through 2009 (27 months). The relative hazards of time to first injury according to baseline socioeconomic status were estimated via Cox proportional hazards models. Risks for injury were not consistent with inverse socioeconomic gradients (adjusted HR 1.07; 95% CI: 0.76 to 1.51 for high vs low economic worry; adjusted HR 1.72; 95% CI: 1.23 to 2.42 for completed university education vs less than high school). Strong increases in the relative hazard for time to first injury were identified for longer work hours on the farm. Socioeconomic factors have been cited as important risk factors for injury on farms. However, our findings suggest that interventions aimed at the prevention of farm injury are better focused on operational factors that increase risk, rather than economic factors per se.
    The Journal of Rural Health 06/2011; 27(3):245-54. DOI:10.1111/j.1748-0361.2010.00344.x · 1.45 Impact Factor
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    ABSTRACT: (1) To apply novel population health theory to the modelling of injury experiences in one particular research context. (2) To enhance understanding of the conditions and practices that lead to farm injury. Prospective, cohort study conducted over 2 years (2007-09). 50 rural municipalities in the Province of Saskatchewan, Canada. 5038 participants from 2169 Saskatchewan farms, contributing 10,092 person-years of follow-up. Individual exposure: self-reported times involved in farm work. Contextual factors: scaled measures describe socioeconomic, physical, and cultural farm environments. Outcome: time to first self-reported farm injury. 450 farm injuries were reported for 370 individuals on 338 farms over 2 years of follow-up. Times involved in farm work were strongly and consistently related to time to first injury event, with strong monotonic increases in risk observed between none, part-time, and full-time work hour categories. Relationships between farm work hours and time to first injury were not modified by the contextual factors. Respondents reporting high versus low levels of physical farm hazards at baseline experienced increased risks for farm injury on follow-up (HR 1.54; 95% CI 1.16 to 1.47). Based on study findings, firm conclusions cannot be drawn about the application of population health theory to the study of farm injury aetiology. Injury prevention efforts should continue to focus on: (1) sound occupational health and safety practices associated with long work hours; (2) physical risks and hazards on farms.
    Injury Prevention 12/2010; 16(6):376-82. DOI:10.1136/ip.2010.026286 · 1.89 Impact Factor
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    ABSTRACT: Agriculture has among the highest recorded exposures to dangerous levels of noise. Studies have demonstrated an increased prevalence of noise-induced hearing loss (NIHL) among youth actively involved in farm work. Since most agricultural worksites are exempt from safety and health regulations, alternative strategies to promote hearing conservation among farm youth must be identified. We are evaluating the long-term effectiveness of a three-year hearing conservation program for farm youth conducted between 1992 and 1996 in Wisconsin, USA. Thirty-four rural schools had been recruited and randomized to intervention or control. The intervention included classroom instruction, distribution of hearing protection devices, direct mailings, noise level assessments, and yearly audiometric testing. The control group received the audiometric testing. In total, 690 high school farm youth completed the study. Students exposed to the hearing conservation program reported increased use of hearing protection devices (OR 7.73; 95% CI: 4.98 to 11.99), but there was no evidence of reduced levels of NIHL where odds ratios varied between 0.88 (95% CI: 0.58 to 1.34) at 3000 HZ to 1.55 (0.89 to 2.69) at 4000 HZ. Since NIHL is cumulative, a three-year study was likely not long enough to evaluate the efficacy of this intervention. A 16-year follow-up study of this hearing conservation program cohort is currently underway. To date, 356 former students have been recruited and enrolled. The results of this long-term follow-up will be available by November, 2010 and will demonstrate the role of early intervention in sustaining hearing protection behaviors and preventing NIHL in young workers.
    138st APHA Annual Meeting and Exposition 2010; 11/2010
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    ABSTRACT: To characterize working hours of adult farm owner-operators and their spouses by season, and to examine associations between working hours and farm safety practices affecting children. We conducted a secondary analysis of cross-sectional survey data collected as part of an existing study of injury and its determinants. Owner-operators reported a median of 60 to 70 hours of farm work per week during warm weather months, with declines in hours over the winter. Spouses reported similar seasonal patterns, although their median reported hours were much lower. Longer farm working hours by owner-operators were marginally associated with increased exposure of teenagers to farm work hazards. Exposures of young children to worksite hazards rose in association with longer farm working hours by spouses. Exposures of children to farm worksite hazards and demands may be consequences of adult long working hours.
    The Journal of Rural Health 09/2010; 26(4):366-72. DOI:10.1111/j.1748-0361.2010.00304.x · 1.45 Impact Factor
  • J H Chang · F A Fathallah · W Pickett · B J Miller · B Marlenga ·
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    ABSTRACT: Farm tractors account for the majority of deaths and injuries among youths working on North American farms. A vehicle operator's field of vision is an important operational aspect for safe driving. However, very little is known about visual limitations of young tractor operators compared to adult operators. The main purpose of this study was to quantify limitations in fields of vision of children with different anthropometry. The study was based on assessment of 42 farm tractors in popular use in the USA. The results showed that youth operators typically had diminished fields of vision compared to the average adult operator. The degree of visual limitation is greatest for objects at close distances and when objects are straight in front of the operator/tractor. This has serious implications in terms of risks for runovers, rollovers and collisions. Study findings may help illuminate the development of policies and guidelines in tractor-related jobs for children. STATEMENT OF RELEVANCE: This study provides an ergonomic approach for evaluation of children's visual limitations in tractor operations. This approach could be used in other related cases, where children are allowed to operate vehicles.
    Ergonomics 06/2010; 53(6):758-66. DOI:10.1080/00140131003671983 · 1.56 Impact Factor
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    ABSTRACT: (1) To conduct a contemporary analysis of historical data on short-term efficacy of a 3-year hearing conservation program conducted from 1992 to 1996 in Wisconsin, USA, with 753 high school students actively involved in farm work; (2) to establish procedures for assessment of hearing loss for use in a recently funded follow-up of this same hearing conservation program cohort. We analyzed a pragmatic cluster-randomized controlled trial, with schools as the unit of randomization. Thirty-four rural schools were recruited and randomized to intervention or control. The intervention included classroom instruction, distribution of hearing protection devices, direct mailings, noise level assessments, and yearly audiometric testing. The control group received the audiometric testing. Students exposed to the hearing conservation program reported more frequent use of hearing protection devices, but there was no evidence of reduced levels of noise-induced hearing loss (NIHL). Our analysis suggests that, since NIHL is cumulative, a 3-year study was likely not long enough to evaluate the efficacy of this intervention. While improvements in reported use of hearing protection devices were noted, the lasting impact of these behaviors is unknown and the finding merits corroboration by longer term objective hearing tests. A follow-up study of the cohort has recently been started.
    Preventive Medicine 10/2009; 49(6):546-52. DOI:10.1016/j.ypmed.2009.09.020 · 3.09 Impact Factor
  • F A Fathallah · J H Chang · W Pickett · B Marlenga ·
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    ABSTRACT: Farm tractor work is commonly assigned to young people on North American farms, where tractors account for the majority of deaths and major portions of non-fatal trauma to working youths. However, little is known about the potential mismatch between the anthropometric and physical characteristics of children and tractor characteristics. The purpose of this study was to evaluate the ability of children of varying ages and percentiles to reach major controls on 45 tractors in common use in the US. The main study finding was that many tractor controls, especially those that are hand-operated, may not be effectively reached by the majority of youth operators aged 12 to 16 years. The study raises further serious questions about the ability of children to safely operate tractors in common use on US farms and calls for reconsideration of age guidelines for the assignment of children to tractor work on farms. This study provides novel ergonomic evidence about the ability of children to reach controls inside agricultural tractor cabins. The approach could be applied in similar situations where youths may operate other vehicles or machines. Study findings support the establishment and refinement of policies and guidelines related to youth tractor operation.
    Ergonomics 05/2009; 52(6):685-94. DOI:10.1080/00140130802524641 · 1.56 Impact Factor
  • Regina M Fisher · Richard L Berg · Barbara Marlenga ·
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    ABSTRACT: Agricultural injuries continue to be an important source of childhood mortality and morbidity. There is an agreement within the injury prevention community that environmental modification is the most effective strategy for injury prevention. A growing trend among dairy farmers in the upper Midwest and Northeast regions of the United States is the adoption of management-intensive grazing (MIG) as a new technique for dairy management that actually encompasses environmental modification, decreasing the reliance on and use of tractors and machinery (major sources of fatal and nonfatal injuries to children). The purpose of this study was to explore how restructuring the work and the work environment through the use of MIG may affect children's exposure to farm worksite hazards. The study specifically focused on the most hazardous farm worksite exposures for children based on injury surveillance data (tractors, machinery, large animals, heights, and water sources). An online survey was sent to 68 Wisconsin agricultural extension agents knowledgeable about dairy operations in their counties to collect data regarding their perceptions of potential childhood farm safety hazards on MIG operations. A total of 31 surveys were returned using the online survey system, resulting in a 46% response rate. Survey results suggest that children on MIG operations do in fact have decreased exposure to farm machinery. However, there was a perceived increase in children's overall worksite exposure, in addition to specific increases in exposure to all-terrain vehicles and animals. Adoption of a MIG system clearly involves changes in exposures for children, and understanding the full impact of these changes will require further study of the effects of these exposure tradeoffs on the risks for injuries of varying nature and severity.
    Journal of Agromedicine 02/2009; 14(2):192-7. DOI:10.1080/10599240902773181 · 0.91 Impact Factor