We have been engaged in the CHAMACOS study (R01ES026994, PI-Eskenazi), a longitudinal cohort study of more than 600 Latino primarily farmworker families (N=600 mother-child dyads, N=1200) in the agricultural Salinas Valley California for 20+ years. The overaching aim of this study has been to investigate the health sequelae of pesticide exposure over the lifecourse from in utero to adulthood. In this proposal, we aim to study the impact of the COVID-19 pandemic on these families. Low-income families, and particularly farmworker families, will likely be disproportionately infected by COVID-19 given cramped living quarters, their ?essential? work status, traveling to work in crowded farmworker buses, and close working conditions on packing lines. In addition, substantial epidemiologic and toxicologic evidence suggests that pesticides, including organophosphates (OPs), organochlorines (OCs), carbamates, pyrethroids, the herbicide glyphosate, and ethylenebisdithiocarbamate (EBDC) fungicides can impact immunologic suppression and increase susceptibility to infectious diseases and more severe disease. For these reasons, we estimate that between 20%-40% of the CHAMACOS cohort will have been infected by January 2021. In addition, we hypothesize that the CHAMACOS cohort will be more impacted by the pandemic given poverty, insecure employment, risk for food scarcity, immigration status, and poor access to health services. For the 600 mother-child dyads, we have collected key information prior to the pandemic on health, financial and food security, and other relevant variables that may have been altered by the pandemic or increased risk of infection.
The specific aims of this proposed supplement are to collect data post-COVID-19 to assess change in health (weight gain, increase in blood pressure, increase in anxiety or depression), food and housing security, access to medical care for COVID-19 or non-COVID-19 related conditions, fear of immigration authorities, barriers to protective behaviors during the pandemic (crowded housing, no indoor running water, workplace policies), and SARS-CoV-2 infection by serology. We will assess whether cumulative pesticide exposure increased risk for infection and disease. Pesticide exposure will be determined in two ways: by using California?s unique Pesticide Use Reporting data linked to 20-year residential history (the lifetime of the child) and using existing biomarkers of exposure (including prenatal and early life exposure of the child). To our knowledge, there is no other study of a similar population given the hard-to-reach nature of this cohort, the richness of the existing data, and our long-term relationship with the families and the community. Thus, our proposal will give a rare window into a population at high-risk of contracting COVID-19 and our unique opportunity to understand how the pandemic affects low-income Latino families who are living and working in a farmworker community is unsurpassed.
Low-income families will be disproportionately affected by the COVID-19 pandemic in terms of negative health sequelae. These deleterious effects are likely to be augmented among Latinos living in agricultural communities, given their previous exposure to pesticides that have the potential to affect the immune system and increase risk of disease, in addition to challenging work and living conditions, poor access to knowledge and protective measures, documentation status, and limited health benefits. This 20-year longitudinal allows us to examine the cumulative effects of agricultural pesticide exposures on susceptibility to COVID-19, in addition to understanding risk and health consequences in this population.
