International Total Worker Health®

Improving farm worker health through a holistic approach to health and safety.

We have partnered with the ColoradoSPH Center for Global Health and two of the largest agricultural enterprises in Central America to better understand the health risks agricultural workers face and determine the most effective, feasible solutions to improve their health, safety, and well-being. Global temperatures are on the rise and as a result, these workers face greater health risks. As part of the University of Colorado Consortium on Climate Change and Health, a group of CU scientists researching the impact of climate on human health, we are working to understand how climate affects workers.   

We are studying the health of sugarcane and banana agricultural workers and evaluating the health and safety programs provided by their employers. Based on our findings, we will offer recommendations to these businesses, emphasizing a Total Worker Health approach to protect workers from safety hazards and support their health and well-being. Since launching this research in 2015, we have conducted health screenings on thousands of workers. ​​​

Current Research

Particulate Exposure and Kidney Health. (March 2021 – December 2026)

Investigators: John Adgate, PhD, MSPH, Lee Newman, MD, MA, Joshua Schaeffer, PhD, Co-Principal Investigators (PI). Funded by: NIH (National Institutes of Health), National Institute for Environmental Health Sciences (NIEHS)

Women's airborne exposure and kidney health in Guatemala. (May 2021 – April 2024)

Investigators: Jaime Butler-Dawson, PhD, MPH, Principal Investigator (PI). Funded by: NIH/NIEHS

Individual and household determinants of renal insufficiency among agricultural workers: A Total Worker Health Approach. (September 1, 2022 – August 31, 2023)

Investigators: Lyndsay Krisher, MS, Principal Investigator (PI). Funded by: CDC/NIOSH Center of Excellence for TWH, Pilot Project

Air pollutants, heat exposure, and kidney health: A longitudinal study in women in Central America

This study aims to contribute to the understanding of the causes, mechanisms, and potential strategies for the prevention of the international epidemic of chronic kidney disease of unknown origin (CKDu). Our central hypothesis is that exposure to high concentrations of airborne contaminants will be associated with kidney injury and inflammation in females at-risk for CKDu in Guatemala and Nicaragua.

Investigators: Lee Newman, MD, MA, Principal Investigator (PI). Funded by: NIEHS

Total Worker Health® Training for Occupational Health and Safety Professionals

A team of recognized experts in leadership training and organizational psychology from the University of Colorado will deliver two weeklong Total Worker Health trainings for occupational professionals at the Instituto Mexicano de Seguro Social (IMSS). The team will examine theories of organizational change and evidence-based ways that workplaces and occupational professionals can implement evidence-based practices.

Investigators: Lee Newman, MD, MA, Principal Investigator (PI). Funded by: Instituto Mexicano de Seguro Social (IMSS)

Highlights

Heat impacting tomato and chili agriculture workers in Jalisco Mexico

Colorado School of Public Health team returns from research trip studying agriculture worker health with the ILO

Sep 7, 2023
Jalisco team

Climate change is impacting our food chain, and the workers who grow, harvest, and package that food. Global temperatures increases affect the health of workers in the agricultural industry.

Researchers from the Center for Health, Work & Environment (CHWE) at the Colorado School of Public Health (ColoradoSPH) have completed their first round of data collection for a two-year heat-related research project with agricultural workers in Jalisco, Mexico, as the implementing partner ofthe International Labour Organization (ILO)'s Vision Zero Fund. The seasoned team of experts from CHWE are working to improve workers’ occupational safety and health in selected supply chains in Mexico.

The study is a collective action approach to understanding and preventing heat-associated impacts of agricultural worker health and safety in Jalisco. This research partnership with the Instituto Mexicano de Seguro Social (IMSS) is led by Principal Investigator (PI) Lee Newman, MD, MA, distinguished professor at the University of Colorado and director for the Center for Health, Work & Environment.


The produce is grown in greenhouses the size of soccer fields. Workers traverse ladders with caution as to not touch the produce with any bare part of their bodies. Temperatures in the greenhouses can reach 100.58 degrees Fahrenheit with 94.3% humidity.

Tomato growhouses

This study explores the same set of workers over two years, comparing the heat impacts on those harvesting versus packaging the produce. The research team is gathering multiple time points different seasons. They are measuring heat exposure, physical activity, heat-mitigation practices, and health status. After data collection, the team will collaborate with study participants to develop an intervention (workers, managers, owners, other stakeholders) in spirit of collective action.

Inside growhouses

Using the Wet Bulb Globe Temperature measure, probes asses the overall heat impact by measuring temperature, humidity and radiation. In addition, ambient temperature humidity is measured by iButtons, worn on the outside of worker's attire.

Jalisco blog

Along with collecting employee biomarkers before and after work, the researchers are also exploring work intensity using the Frimat and Chamous ergonomic method. Collecting multiple points of measurement contributes to a holistic assesment of how workers are impacted by heat through their daily work, demonstrating a Total Worker Health® approach to research and interventions. 

surveys

Through surveys, participants are providing information on their own understanding and perceptions of heat impacts to their health and mitigation efforts. At the end of the workday, the team selected a few workers to take an National Institutes of Health (NIH) cognitive test that measures thinking, knowing, remembering, judging, and problem-solving. Pictured here are researching administering surveys in the employee gathering area.

Vitals 
In year two, the team will implement the intervention and repeat data collection of the same measures to assess how effective the intervention is on improving the health of workers. As part of the study, participants receive clinical information about  their health including results of blood and urine tests to detect common health conditions like diabetes, kidney disease, hypertension, and anemia.

Stay tuned for more study updates. Our newsletter is the best way to hear about what we are doing!

Jalisco

Written by Laura Veith, communications and media program manager for the Center for Health, Work & Environment at the ColoradoSPH.

Categories: Center for Health, Work & Environment | Tags: international-twh

Total Worker Health® is a registered trademark of the U.S. Department of Health and Human Services (HHS). Participation by the Center for Health, Work & Environment does not imply endorsement by HHS, the Centers for Disease Control and Prevention, or the National Institute for Occupational Safety and Health.

Centers for Health, Work & Environment

Colorado School of Public Health

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13001 East 17th Place

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Mail Stop B119

Aurora, CO 80045

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