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Am J Public Health. 2017 Aug;107(8):1296-1303. doi: 10.2105/AJPH.2017.303820. Epub 2017 Jun 22.

Dust Exposure and Coccidioidomycosis Prevention Among Solar Power Farm Construction Workers in California.

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All of the authors are with California Department of Public Health, Richmond. Jason A. Wilken is also with the Office of Public Health Preparedness and Response, Career Epidemiology Field Officer Program, Centers for Disease Control and Prevention, Atlanta, GA.



To investigate if work activities, dust exposure, and protection measures were associated with a 2011 to 2014 coccidioidomycosis outbreak among workers constructing 2 solar farms in California.


In 2013, we mailed self-administered questionnaires to employees who were onsite at the solar farms where the outbreak occurred to identify cases of clinical coccidioidomycosis and compare with asymptomatic workers by using multivariate logistic regression.


When we compared 89 workers with clinical coccidioidomycosis to 325 asymptomatic workers, frequently being in a dust cloud or storm (odds ratio [OR] = 5.93; 95% confidence interval [CI] = 3.18, 11.06) significantly increased the odds of clinical coccidioidomycosis, whereas frequently wetting soil before soil-disturbing activity (OR = 0.42; 95% CI = 0.24, 0.75) was protective. When we controlled for being in a dust cloud or storm, frequent soil disturbance significantly increased the odds of clinical coccidioidomycosis only among those who reported wearing a respirator infrequently (OR = 2.31; 95% CI = 1.27, 4.21).


Utilization of personal and employer-driven safety practices and increased coccidioidomycosis awareness among construction workers should be considered during the planning of any construction work in coccidioidomycosis-endemic regions to prevent occupational infections and outbreaks.

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