Development of point-of-care mobile health technology to reduce heat and pesticides-induced farmworker health disparity

Abstract
Migrant and seasonal farmworkers (MSFWs) are predominantly Hispanic and continue to face serious health
inequity and disparity in the United States. They are at high risk of developing acute and chronic diseases that
can be caused by two top hazards at work: extreme heat and pesticides.
underlying health conditions that may develop into chronic kidney disease (CKD) while pesticides exposure
can lead to acute or chronic poisoning. The combination of heat and pesticides could exacerbate
health conditions for farmworkers. Moreover, farmworkers have limited access to regular healthcare due to
physical, economic, infrastructural, knowledge, and culture barriers, with the result being that sick farmworkers
cannot get diagnosed and treated in a timely manner. All these may contribute to the short life expectancy
(average of 49-years) of farmworkers. Thus, early detection and timely intervention is critical for farm workers
to reduce the risk of developing various diseases caused by heat and pesticides.
Extreme heat exposure can cause
underlying
Existing diagnostic assays for
the detection of CKD and pesticides poisoning such as calorimetric creatinine assays and Ellman assays for
measuring blood acetylcholinesterase (AChE) are generally performed in centralized laboratories, are
expensive, and have a long turnaround time. Thus, there is a critical need to develop new point-of-care (POC)
technologies and new approaches for farmworkers to overcome these barriers to get healthcare and health
literacy and improve their quality of life. We have developed and validated an integrated
smartphone/nanosensor device for onsite rapid and sensitive detection of personal exposure to pesticides
using minimally-invasive finger stick blood, which was supported by an NIH NIEHS STTR grant
(R41ES032388). In this proposal, we will expand this technology and develop a smartphone-based multiplex
nanosensing platform and a health education app for farmworkers. The multiplex nanosensing platform can be
applied for early and fast screening of pesticide exposure and kidney diseases using a tiny finger-stick blood
for farmworkers. The health education app can be used by farmworkers to learn heat and pesticides-related
health information. The long-term goal of this research is to reduce farmworker health disparity and improve
farmworker health through providing farmworkers with inexpensive, efficient, and new mobile health technology
for rapid home screening, point-of-care (POC) testing, and health education. We will have four aims. In aim 1,
we will develop nanosensors for measuring creatinine and acetylcholinesterase activity; In aim 2, we will
develop a multiplexing resistance meter with Bluetooth and evaluate the analytical performance of the
multiplex nanosensing platform for simultaneously measuring creatinine and AChE using spiked blood
samples; In aim 3, we will develop an app for the multiplex nanosensing platform and a health education app
and associated cloud for farmworkers; Finally, we will validate the multiplex nanosensing platform and health
education app with farmworkers through the collaboration with Farmworker Association of Florida with a
ultimate goal of reducing heat and pesticides-induced farmworker health disparity. The combination of this new
technology and community-based participatory research on the heat and pesticide exposure with farmworkers
provides a feasible approach to engage this vulnerable population in the health disparity research. This project
is significant and innovative because it will provide a new approach and cost-effective and efficient technology
for farmworker to address the high health risks posed from heat and pesticides and prevent farmworkers from
developing diseases, thus reducing farmworker health disparity.