Research and Health Care Tools

Additional Research & Health Care Tools Publications

Armstrong J, Fitzpatrick C, Loftus C, Yost M, Tchong-French M, Karr C. Development of a unique multi-contaminant air sampling device for a childhood asthma cohort in an agricultural environment. Enriron Sci Processes Impacts. 2013 Jul. Advanced Release. DOI: 10.1039/c3em00330b.

Keifer M, Gasperini F, Robson M. Pesticides and other chemicals: minimizing worker exposure. J Agromedicine. 2010 Jul;15(3):264-74.

Hofmann JN, Carden A, Fenske RA, Ruark HE, Keifer MC. Evaluation of a clinic-based cholinesterase test kit for the Washington State Cholinesterase Monitoring Program. Am J Ind Med. 2008 Jul; 51(7): 532-8. PMID: 18459125.

Crowe JL, Keifer MC, Salazar MK. Striving to provide opportunities for farm worker community participation in research. J Agric Saf Health. 2008 Apr;14(2):205-19. PMID: 18524285.

Boiko P, Katon W, Guerra J.C., Mazzon S. An Audiotaped Mental Health Evaluation Tool for Hispanic Immigrants With a Range of Literacy Levels, Journal of Immigrant Health, Vol. 7, No.1, January 2005. Springer Link Online Abstract

Doran EM, Fenske RA, Kissel JC, Curl CL, Simcox NJ. Impact of dermal absorption factors in occupational exposure assessment: comparison of two models for agricultural reentry worker exposure to azinphosmethyl. Appl Occup Environ Hyg. 2003;18(9):669-677.

Fenske RA, Simcox NJ, Camp JE, Hines CJ. Comparison of three methods for assessment of hand exposure to azinphos-methyl (guthion) during apple thinning. Appl Occup Environ Hyg. 1999;14:618-623.

Lu C, Fenske RA. Dermal transfer of pesticide residues from treated surfaces: comparison of hand press, hand drag, wipe and PUF roller measurements following residential flea control applications. Environ Health Perspect. 1999;107:463-467. 

Moate T, Lu C, Fenske RA, Hahne R, Kalman D. Improved cleanup and determination method of dialkyl phosphates in the urine of children exposed to organophosphorous insecticides. J. Anal. Toxicol. 1999;23:230-236.

Keifer M. The clinical laboratory in the diagnosis of overexposure to agrochemicals. Laboratory Medicine. 1998;29(11):689-695. n/a

Kissel JC, Shirai JH, Richter KY, Fenske RA. Empirical investigation of hand-to-mouth transfer of soil. Bull Environ Contam Toxicol. 1998;60:379-386.

Kissel JC, Shirai JH, Richter KY, Fenske RA. Investigation of dermal contact with soil in controlled trials. J Soil Contam. 1998;7:737-752. n/a

Lu C, Anderson LC, Morgan MS, Fenske RA. Salivary concentrations of atrazine reflect free atrazine plasma levels in rats. J Toxicol Environ Health. 1998;53:283-292.

Miller M, Keifer M. Cholinesterase monitoring as a predictor for overexposure to pesticides. Streamline. 1998;3(3):1-2. Reprint Available by Request

Keifer MC, Howard E. Appendix: General Pesticide Information on the Worldwide Web. Occupational Medicine State of the Art Reviews. 1997;12(2):399-401. Reprint Available by Request

Keifer MC, Arne KH. Toxicity Testing of Pesticides Sold in the United States. Occupational Medicine State of the Art Reviews. 1997;12(2):365-370. Reprint Available by Request

Fenske RA, Birnbaum SG. Second generation video imaging technique for assessing dermal exposure (VITAE System). Am Ind Hyg Assoc J. 1997;58(9):636-645. Informaworld Abstract

Lu C, Fenske RA, Anderson LC. Determination of atrazine levels in whole saliva and plasma in rats: potential of salivary monitoring for occupational exposure. J Toxicol Environ Health. 1997;50:101-111 .

Lu C, Anderson LC, Morgan MS, Fenske RA. Correspondence of salivary and plasma concentrations of atrazine in rats under variable salivary flow rate and plasma concentration. J Toxicol Environ Health. 1997;52:317-329. 

Yuknavage K, Fenske R, Kalman D, Keifer M, Fulong C. Simulated dermal contamination with capillary samples and field cholinesterase biomonitoring. J Toxicol Environ Health. 1997;51:35-55.

Zahm SH, Blair A, and the Farm Workers Epidemiology Research Group (Keifer, M, member). Cancer feasibility studies among migrant farm workers. Am J Industrial Medicine. 1997;32:301-302. Reprint Available by Request

Kissel JC, Richter KY, Fenske RA: Investigation of factors affecting soil adherence to skin using a hand-press technique. Bull Environ Contam Toxicol. 1996;56:722-728. n/a

Amaya A, Keifer M, McConnell R. EQM testmate OP cholinesterase kit - comment. Occupational and Environmental Medicine. 1996;53:358. n/a

Black KG, Fenske RA. Dislodgeability of chlorpyrifos and fluorescent tracer residues on turf: a comparison of wipe and foliar wash sampling techniques. Arch Environ Contam Toxicol. 1996;31:563-570.

Kissel JC, Richter KY, Fenske RA. Field measurement of dermal soil loading attributable to various activities: implications for exposure assessment. Risk Analysis. 1996;16:115-125. n/a

Fenske RA. Dermal exposure assessment techniques. Annals Occup Hyg. 1993;37:687-706.

Rosenstock L, Daniell W, Barnhart S, Stover B, Castorina J, Mason S, Heyer N, Hubbard R, Kaufman J, Brodkin C, Keifer M. The ten-year experience of an academically affiliated occupational and environmental medicine clinic. West J Med. 1992;157:425-429.n/a

Feasibility: Diagnosis of Mental Illness among Farm Workers with a Range of Literacy (NIOSH/CDC, 2002-2003)

With this project, PNASH developed an audiotape survey to assist in the diagnoses of farm worker patients with depression or other mental illnesses. This tool was developed for farmworkers who speak Spanish and have limited literacy skills. Our study found that the self-administered, tape recorded survey was reliable for diagnosis of mental illness. These audiotapes are available for use by health care providers.


Icon-Based Occupational History (NIOSH/CDC, 1995-1998)

This project sought to expand and validate an icon based occupational history questionnaire for use with Hispanic migrant and seasonal farm workers. The questionnaire was specially designed to obtain lifetime work histories from illiterate or semiliterate subject for use in long-term exposure studies and has been well-received by both interviewers and subjects. It was adapted for use in leukemia/brain cancer studies in Costa Rica and is available for use to other researchers.

Publication List

Optical Assessment of Dermal Exposure and Absorption (NIEHS, 2000-2004)

The work of the PNASH Center has led to improved methods of dermal exposure assessment for agricultural workers and more accurate models for dermal absorption of pesticides. Our work with the direct-reading ATR-FTIR method shows promise as a rapid and inexpensive method for determining pesticide concentrations on the skin and uptake rates.

Publication List

Pilot Application of Cholinesterase Monitoring of Pesticide Applicators in Washington State (NIOSH/CDC, 1996-2001)

This study evaluated the accuracy of cholinesterase determinations performed on the EQM Testmate Kit™ in field conditions as compared to those conducted in a laboratory. It also examined whether a field-based kit provides advantages in promptness of worker removal. Seventy-five orchard workers with regular exposure to Guthion, Diazinon, and several other organophosphate and N-methyl carbamate pesticides had samples of their blood and urine taken during the growing season. Samples were also obtained from five unexposed workers. Both the Testmate Kit and conventional venous laboratory testing for plasma and erythrocyte cholinesterase measurements were performed on the samples. Urinary metabolites confirmed that exposure was occurring in the exposed group but no significant mean cholinesterase changes were noted with either laboratory or field based methods. Preliminary findings indicated relatively good performance of the Testmate Kit under field conditions as compared to the laboratory.

Pilot Project: Developing, Testing an Objective Tool for Measuring Postural and Vibrational Exposures During Forestry and Agricultural Work (PNASH Pilot, 2001-2005)

Forty-two noise exposures and 164 whole-body (WBV) and hand-arm (HAV) vibration exposures were collected from 43 forestry workers in six trades employed by two forestry companies. Data were collected on 10 days over 8 weeks during a various felling, logging, and log handling operations. Up to 5 volunteers were monitored for noise and vibration daily using datalogging noise dosimeters, which provided daily time-weighted averages (TWAs) and 1-min averages; and a precision sound level meter equipped to measure human vibration, which provided triaxial HAV and WBV event-weighted averages (AEQs). Workers completed a short questionnaire throughout the workday detailing the timing and number of tasks performed and equipment used. Substantial overexposures to noise and vibration were seen; for example, 60% of Occupational Safety and Health Administration (OSHA) TWAs and 83% of National Institute for Occupational Safety and Health (NIOSH) noise TWAs exceeded 85 dBA, 33-53% of the axis-specific HAV AEQs exceeded the 8-hour American Conference of Governmental Industrial Hygienists' HAV threshold limit value, and 34% of all summary weighted WBV AEQs exceeded the Commission of the European Communities' 8-hour exposure limit. The mean for 99 WBV summary weighted AEQ was 3.53 6 7.12 m/sec2, whereas the mean for 65 HAV summary weighted AEQ was 5.45 6 5.25m/sec2. The mean OSHA TWA was 86.1 6 6.2 dBA, whereas the mean NIOSH TWA was 90.2 6 5.1 dBA. The task and tool with the highest exposure levels were unveiling chokers on landings and chain saws (noise), log processing and frontend loaders (WBV), and notching stumps and chain saws (HAV). An internal validation substudy indicated excellent agreement between worker-reported and researcher-documented task and tools.

Publication List
Neitzel, N. Yost, M. Task-Based Assessment of Occupational Vibration and Noise Exposures in Forestry Workers. AIHA Journal, 63:617–627 (2002)

Pilot Project: Development of a Work Stress Survey for Farmworkers (PNASH Small Grant 2011-2012)

Workers in jobs with high work demands and low personal control exhibit physiological stress responses. In agriculture in particular, work is known for its heavy burden of stress. This one-year project is developing a culturally appropriate stress survey for ag workers to compare stress levels during high and low work demand periods.

Pilot Project: Finding Common Ground: Developing, Testing, and Evaluating a Narrative Based Model for Presenting Safety Information in Two Socially Diverse Farm Communities (PNASH Pilot, 2001-2004)

This project was conducted through the EWU Center for Farm Safety and Health, which has compared formal and informal (through story telling) communication models used to promote safety. The two models have been tested with intergenerational family farmers and non-intergenerational farmers. This project identified the variables and allowed us to test the efficacy of incorporating informal discourse into formalized, farm safety intervention strategies.

Pilot Project: Methods for Accessing Pesticide/Nitrate Environmental Exposure Databases (PNASH Pilot, 1998-1999)

Agricultural use of pesticides and fertilizers has grown dramatically in the last several years. Contamination of the hydrologic system by these chemicals is an increasing concern and much effort has been made to build databases containing measurements of these chemicals in drinking water sources. These geographically-referenced data (accessible by latitude/longitude coordinates of the target residence or facility) have yet to be used in epidemiologic studies of health outcomes. This project investigated the use of Global Positioning System (GPS)-obtained coordinates for linkage of environmental exposure data (pesticide/nitrate levels in drinking water).

Pilot Project: Validation of Sampling and Analytic Techniques for Fungi and Bacteria in Agricultural Organic Dust Exposure (NIOSH/CDC, 1997-2000)

The main goal of this project was to develop a validated questionnaire for the detection of asthma in community-based studies of Spanish-speaking Mexican populations in Washington State. A secondary goal was to collect pilot prevalence data on asthma in the Yakima Valley Hispanic population. Asthma, now recognized as one of the most common occupational lung diseases, is associated with many differing agricultural exposures. The Spanish-speaking migrant and seasonal farm worker population represents a large percentage of Region X and the U.S. agricultural workforce, but relatively little is known about asthma in this population. One major reason is the absence of a sensitive and specific asthma questionnaire. This project assembled a single translated respiratory symptom questionnaire from previously applied respiratory symptom surveys, translated and back translated and applied by an interviewer to 50 asthmatics and 50 non-asthmatics recruited from the Toppenish Farm Worker Clinic. Then, 10 teams of graduate students applied the questionnaire among more than 100 middle Yakima Valley residents in a pilot survey to obtain a crude prevalence estimate of asthma to be used as preliminary data for a future larger application.

Validation of an Asthma Questionnaire in Spanish (PNASH Pilot, 1995-2000)

Researchers characterized the relationships between various bioaerosol-related assays during composting operations using agricultural wastes. The assays included were standard microbiological assays (high and low temperature incubation for fungi and bacteria) on samples taken on filter cassettes, 1-3 b d glucan, possibly 1-6 b d glucan, and an extracellular polysacharride (EPS) specifically associated with aspergillus and penicillium species. Sampling was conducted during both winter and spring/summer conditions at a variety of operations composting yard waste, biosolids, agricultural waste (including fruit pulp and mint sludge), and dairy manure.

Washington State Cholinesterase Monitoring Rule Evaluation: Medical Monitoring Education, Informed Consent for Handlers
 (NIOSH/CDC, 1995-2000)

In 2004, the state of Washington began requiring the medical monitoring of farm workers who work frequently with high toxicity pesticides. Washington follows only California in adopting this type of policy, presenting the opportunity for creating a model program. PNASH helped the state build the program by ensuring that there are well-developed and evaluated training programs for the medical providers who will work with employees and employers, and informed consent procedures for participating workers, many with low literacy.
These efforts built upon interagency partnerships, informational interviews, and focus groups; drew on the experience of California’s monitoring program; and adapted their materials for use in Washington.

Publication List & Provider Information