Coccidioidomycosis is an important infectious health risk in California, especially in the dry San Joaquin Valley, which is a major center of agricultur. Caused by the soil-dwelling fungus Coccidioides immitis, exposure and infection may occur when high winds or human activity (e.g., agriculture, construction) aerosolize dust and infectious spores. High endemicity for Coccidioides immitis in California's San Joaquin Valley is of special concern because of the region's agricultural importance. Persons of Hispanic ancestry predominate among the agricultural labor force and are at increased risk for disseminated disease. Whereas agriculture has long been recognized for increased risk for coccidioidomycosis, studies have lacked precision for identifying high-risk crops or tasks. Moreover, there is little information on the knowledge levels and understanding of coccidioidomycosis among agricultural workers. The proposed work will contribute to the overall goal of reducing coccidioidomycosis in agricultural workers by (1) conducting a survey to assess knowledge, attitudes, beliefs, and behaviors regarding coccidioidomycosis among 100 agricultural workers in Kern County, California, a highly endemic area; (2) conducting a case-control study (100 cases, 100 controls) to identify crops and agricultural work activities associated with coccidioidomycosis; (3) exploratory sampling of respirable dusts for Coccidioides, and (4) initiating work on translational preventive and educational programs designed to reduce the burden of coccidioidomycosis. Cross-sectors: while focused on the Agriculture, Forestry and Fishing sector, the proposed work addresses several of NIOSH's 24 industrial cross-sectors. These include Communication and Information Dissemination (through assessment of knowledge and development of educational prevention programs), Exposure Assessment (through innovative measurements Coccidioides in respirable dusts), Occupational Health Disparities (through a focus on farm workers, predominantly Hispanic, at increased risk for coccidioidomycosis), and Respiratory Diseases (through the focus on coccidioidomycosis). Expected outcomes and outputs: The major immediate outcome from the proposed work is improved understanding regarding (1) knowledge, attitudes, beliefs, behaviors relevant to coccidioidomycosis and (2) high-risk circumstances (i.e., crops and activities) among agricultural workers. Findings will be used to develop prevention programs (output) and lead to exposure reduction (intermediate outcome) to ultimately facilitate lowering of the health burden of coccidioidomycosis in agricultural workers (end outcome).
Coccidioidomycosis (Valley Fever) is a lung infection caused by the soil-dwelling fungus, Coccidioides immitis, which is common in California's San Joaquin Valley and parts of the Southwest. Farm workers are at increased risk, as are persons of Hispanic, Filipino, and African- American ancestry. This study aims to assess knowledge about coccidioidomycosis among farm workers and identify high-risk work activities; this information will be used to develop preventive and educational programs to reduce the health burden of coccidioidomycosis in agricultural workers.