Outdoor workers need more protections from Valley fever

Outdoor workers in areas where Valley fever is an increasing threat need stronger protections to remain healthy, say researchers at UC Berkeley and the University of Michigan

Valley fever is endemic and increasing in the Southwestern U.S., with numerous documented outbreaks among construction crews, wildland firefighters, military personnel, prison employees, archeologists, and others who work outdoors. Workers can acquire the disease through inhalation of Coccidioides fungal spores that become airborne when soil is disturbed. It is recognized as a work-related disease in California, but not in Arizona or other states where it is also now widespread.

In a recent paper published in the American Journal of Industrial Medicine, the Berkeley and Michigan researchers lay out strategies to improve reporting and tracking of occupation among Valley fever cases.

“We know that outbreaks of Valley fever have occurred among construction workers, wildland firefighters, and other outdoor workers, but we need more consistent and complete data on Valley fever patients’ recent job history to determine when Valley fever is a work-related disease,” said lead author, Juliana Bartels, MPH, who until recently was a graduate student researcher at UC Berkeley School of Public Health and is now a fellow in the California epidemiologic investigation service. “Evidence that Valley fever is work-related can help physicians know when to suspect Valley fever as the cause of community-acquired pneumonia, and can support public health and legislative actions to protect workers through increased education and training.”

The researchers recommend new methods of electronic case reporting via electronic medical records for Valley fever case reports and emphasize the key role of clinicians in collecting and recording patient occupation and industry as part of their social histories. This would help to identify worker populations with higher rates of Valley fever, provide evidence for worker compensation claims of work-related infections, expedite the identification of workplace outbreaks, and support the development of more protective legislation to educate workers about risks and train them on prevention methods.

Currently, most Valley fever case reports to local and state health jurisdictions are sent via automated lab reports or manual case reports, which often lack information on patient occupation. “The paper’s authors—experts in occupational health—highlight how collecting data on occupation and industry can enhance case reporting of Valley fever,” said Professor Justin Remais, principal investigator of a major Valley fever research initiative at Berkeley. “More comprehensive data on occupation among Valley fever cases is an essential step to prevent the disease among highly exposed worker populations,” Remais added.