Lantz P M, Dupuis L, Reding D, Krauska M, Lappe K
Marshfield Medical Research and Education Foundation, WI 54449-5790.
Public Health Rep. 1994 Jul-Aug;109(4):512-20.
Hispanic migrant agricultural workers' exposure to pesticides and other agrichemicals places them at increased risk for a variety of acute and chronic conditions, including cancer. As a socioeconomically disadvantaged group, migrant workers also face many barriers to effective cancer control. In 1992, a series of focus groups was held with 55 Hispanic migrant agricultural workers (22 women, 33 men) in central Wisconsin to gather information on their knowledge and attitudes regarding cancer etiology and treatment, their practices regarding cancer screening and early detection, and their concerns regarding occupational exposure to pesticides. Beliefs that pesticides are toxic and can cause health problems were common among participants. In addition, however, participants reported that they are reluctant to demand occupational protections to which they are entitled because they are afraid of losing their jobs. Study results also suggest that barriers to effective primary and secondary prevention of cancer in this Hispanic migrant agricultural worker population include knowledge and information barriers, cultural barriers, and socioeconomic barriers. A lack of knowledge and information regarding the causes of cancer, its prevention, and its early detection and treatment was evident among participants, which in turn was reflected in strong fatalistic attitudes toward the disease. Cultural barriers included attitudes of embarrassment and shame associated with physical examinations and women's strong discomfort with male clinicians. Socioeconomic barriers to secondary prevention included the cost of obtaining health services, time constraints associated with the need to work and long working days, and a lack of transportation. Efforts to improve cancer screening as well as other preventive health services in the Hispanic migrant agricultural worker population must acknowledge these barriers and address as many of them as possible to be successful.
西班牙裔流动农业工人接触农药和其他农用化学品，使他们面临患包括癌症在内的各种急慢性疾病的风险增加。作为一个社会经济上处于不利地位的群体，流动工人在有效控制癌症方面也面临许多障碍。1992年，在威斯康星州中部与55名西班牙裔流动农业工人（22名女性，33名男性）举行了一系列焦点小组讨论，以收集他们对癌症病因和治疗的知识与态度、癌症筛查和早期检测的做法，以及他们对职业接触农药的担忧。参与者普遍认为农药有毒并会导致健康问题。然而，此外，参与者报告说，他们不愿意要求享有应得的职业保护，因为他们担心失去工作。研究结果还表明，在这个西班牙裔流动农业工人群体中，有效开展癌症一级和二级预防的障碍包括知识和信息障碍、文化障碍以及社会经济障碍。参与者明显缺乏关于癌症病因、预防、早期检测和治疗的知识和信息，这反过来又反映在对该疾病强烈的宿命论态度上。文化障碍包括与体格检查相关的尴尬和羞耻态度，以及女性对男性临床医生的强烈不适感。二级预防的社会经济障碍包括获得医疗服务的成本、与工作需求和长工作日相关的时间限制，以及缺乏交通工具。要在西班牙裔流动农业工人群体中改善癌症筛查以及其他预防性健康服务，就必须认识到这些障碍，并尽可能多地加以解决，才能取得成功。
