title: Comorbidity of tinea pedis and onychomycosis and evaluation of risk factors in Latino immigrant poultry processing and other manual laborers.
abstract: OBJECTIVE
  Latino immigrant workers experience elevated rates of skin disease that result from their working and living conditions. Working in manual occupations exposes workers to a variety of challenges, including occlusive shoes, vigorous physical activity, and wet conditions. These challenges predispose workers to fungal infection. The objectives of this article are to examine the comorbidity of tinea pedis and onychomycosis and to identify possible risk factors among Latino immigrant poultry and nonpoultry workers in western North Carolina.
  
  
  METHODS
  Data were obtained from a cross-sectional study conducted between June 2009 and November 2010 in rural western North Carolina among 518 manual Latino immigrant workers to assess their occupational injuries. Participants completed a face-to-face interview and a dermatologic examination.
  
  
  RESULTS
  Nearly one-third of the participants (32%) were diagnosed as having onychomycosis and more than one-third (37.8%) were diagnosed as having tinea pedis. There was a greater prevalence of tinea pedis in men than women (71.3% vs 28.7%, respectively). Of the 518 participants, 121 (23.5%) had both conditions. Participants who reported the use of occlusive shoes as "always" or "most of the time" had a higher prevalence of comorbid onychomycosis and tinea pedis than the rest of the group.
  
  
  CONCLUSIONS
  Comorbidity of tinea pedis and onychomycosis is common among immigrant Latino men and women who perform manual labor. Further studies confirming the presence and type of dermatophyte should be conducted.
authors.affiliation: From the Departments of Dermatology, Epidemiology and Prevention, Biostatistical Sciences, and Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: Rita
authors.initials: R
authors.lastname: Pichardo-Geisinger
authors.affiliation: From the Departments of Dermatology, Epidemiology and Prevention, Biostatistical Sciences, and Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: Dana C
authors.initials: DC
authors.lastname: Mora
authors.affiliation: From the Departments of Dermatology, Epidemiology and Prevention, Biostatistical Sciences, and Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: Jill C
authors.initials: JC
authors.lastname: Newman
authors.affiliation: From the Departments of Dermatology, Epidemiology and Prevention, Biostatistical Sciences, and Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Arcury
authors.affiliation: From the Departments of Dermatology, Epidemiology and Prevention, Biostatistical Sciences, and Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: Steven R
authors.initials: SR
authors.lastname: Feldman
authors.affiliation: From the Departments of Dermatology, Epidemiology and Prevention, Biostatistical Sciences, and Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: Sara A
authors.initials: SA
authors.lastname: Quandt
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D015897:Comorbidity; D003430:Cross-Sectional Studies; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008462:Meat-Packing Industry / Q000706:statistics & numerical data*; D009657:North Carolina / Q000453:epidemiology; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology; D014009:Onychomycosis / Q000453:epidemiology* / Q000209:etiology; D011200:Poultry; D012307:Risk Factors; D012737:Sex Factors; D014008:Tinea Pedis / Q000453:epidemiology* / Q000209:etiology; D055815:Young Adult