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Tuberculosis Prevalence Among US Crop-Workers, 2000 to 2012: Trends and Contributing Factors

Medel-Herrero, Alvaro, PhD, MBA; Martínez-López, Beatriz, DVM, MPVM, PhD; Silva-del-Rio, Noelia, DVM, PhD; Pires, Alda F., DVM, MPVM, PhD, Dipl. ACVPM; Edmondson, Anita, BVM&S, MPVM, MRCVS; Schenker, Marc, MD, MPH

Journal of Occupational and Environmental Medicine: July 2018 - Volume 60 - Issue 7 - p 603–611
doi: 10.1097/JOM.0000000000001257

Objective: We intend to study tuberculosis (TB) in one of the poorest communities in the US, hired agriculture workers, for most recent years (2000 to 2012) including the last recession period.

Methods: Time-chart, simple mean differences, and logistic regressions were used to describe TB-prevalence and risk factors among US crop-workers. Data were drawn from the National Agricultural Workers Survey (NAWS).

Results: A high TB-prevalence was found among crop-workers with a dramatically increasing trend in recent years. Hispanic ethnicity, having farmworker family members, the presence of health insurance, and good spoken English were associated with an increased TB-prevalence.

Conclusion: We found risk factors related to ethnicity and poor access to health care, a strong association between agriculture activity and TB, and an increase of TB-cases due to the 2008 downturn in this underserved population. We urge the health authorities to control this epidemic.

Center for Health and the Environment, University of California, Davis, California (Dr Medel-Herrero); Center for Animal Disease Modeling and Surveillance, Department of Medicine & Epidemiology, School of Veterinary Medicine, University of California, Davis, California (Dr Martínez-López); Veterinary Medicine Teaching and Research Center, Veterinary Medicine Extension, University of California, Davis, California (Dr Silva-del-Rio); Population Health & Reproduction, Veterinary Medicine Extension Veterinary Medicine Extension, University of California, Davis, California (Dr Pires); California Department of Food and Agriculture, Animal Health and Food Safety Services, Animal Health Branch, Sacramento, California (Dr Edmondson); Department of Public Health Sciences, University of California, Davis, California (Dr Schenker); Western Center for Agricultural Health and Safety, University of California, Davis, California (Dr Schenker).

Address correspondence to: Alvaro Medel-Herrero, PhD, MBA, Center for Health and the Environment, University of California, Davis, Old Davis Road, Davis, CA 95616 (

The authors declare that there is no conflict of interest regarding the publication of this paper. This article does not contain any studies with human participants or animals performed by any of the authors.

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

The authors report no conflicts of interest.

Copyright © 2018 by the American College of Occupational and Environmental Medicine