| Summary |
Agriculture is one of the most dangerous occupations in the United States, including a disproportion risk of death from heat-related illnesses (HRIs). Proper hydration mitigates HRI, yet farmworkers report not drinking water due to various pretexts. To date, no known studies have specifically focused on NC farmworker hydration status or fluid intake; therefore, the purpose of the dissertation research study was to explore how culture, place, and environmental heat stress influence fluid intake and hydration status among a sub-set of Latino farmworkers living in eastern North Carolina. A community-informed, sequential exploratory mixed methods research design was conducted in July and August 2020. In Phase I we conducted focus group discussions with farmworkers to gain farmworker perceptions on their fluid intake. In Phase II we collected a cross-sectional survey, a beverage questionnaire, wet bulb globe temperatures and physiological markers of hydration status. The final convenience samples included 28 participants in Phase I and 30 participants in Phase II; all were male, migrant Latino farmworkers. Twenty-six (87%) of the final sample in Phase II also took part in Phase I, with the mean age of participants in that latter phase of 38.7 (SD = 8.7) years. Transcripts from the FGDs were analyzed using content analysis. Parametric analyses using the quantitative data were performed via SPSS v.27. Qualitative and quantitative data was integrated using a meta-matrix. From Phase I, the two major thematic findings were Absence of Protection and Freedom to Drink. Farmworkers consistently perceived extreme outdoor temperatures as the greatest barrier and reported self-care sacrifices, incomplete hydration education, and workplace water accessibility and quality issues. For Phase II, 46.7% of farmworkers' pre-shift urine specific gravity (USG) indicated dehydration, increased to 100% at post-shift, which was a significant increase across the shift, t (24) = -6.765, p [less-than] .001 (two-tailed). Evaluating hydrated and dehydrated groups further highlighted the importance of both time at work and heat stress to hydration status. Integration of Phase I and II data revealed congruent findings related to extreme heat, few breaks, and poor housing. Findings of this study will support the development of interventions and support policy change to protect against farmworker HRI. It will also provide further insight into farmworker kidney health and the health effects of extreme environmental heat stress. As the nation's most trusted profession, nurses are in a great position to protect vulnerable populations. As climate change is the greatest public health this century, nurses can and should lead the call for climate and social justice and ease the burden of climate change on human health. |
