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.

Project Narrative This project is to develop a cost-effective, efficient, and mobile health detection technology for rapid home testing and point-of-care testing of blood creatine and acetylcholinesterase for assessment of heat-related illness and pesticide exposure using minimally-invasive finger-stick blood. Additionally, we will develop a health education app for farmworkers to learn heat and pesticides-related health information. The goal of this research is to overcome/eliminate the issues associated with farmworker health disparity: physical, economic, infrastructural, knowledge, language, and cultural barriers to healthcare resources and health literacy.