Occupational Research Agenda for Northwest Farming

Pacific Northwest Agricultural Safety and Health Center

WORK ENVIRONMENT & WORKFORCE



THE SUBTOPICS in this category reflect hazards in the agricultural work environment, the populations who make up the majority of the workforce, and factors, which may, directly or indirectly, affect health and safety risks. Research is needed to understand the complex interactions between traditional risk factors and the various social and economic forces that operate in farming. The organization of work is increasingly recognized as an important component in promoting health and safety, but insufficient research is available to provide guidance to managers, producers, and employees. Effective communication is essential to the successful implementation of workplace changes designed to prevent injury and illness.

CHEMICAL EXPOSURES



Agricultural chemical exposure is common on most farms in the Northwest, affecting both producers and farm workers. Most concerns have focused on pesticides, but exposure to fertilizers and air contaminants, such as carbon monoxide and diesel exhaust, may also carry health risks. Chemical exposures among children living on or near farms has also become a public health concern. Research is needed to better characterize exposure pathways and levels, estimate acute and chronic health risks, understand the effects of mixed chemical exposures, and design effective interventions to reduce potentially harmful exposures. There is a clear need for worker training and risk communication that is multilingual and culturally specific.

[NIOSH NORA: Mixed Exposures]

IMPORTANCE

Agricultural pesticide exposure has been a concern among Northwest producers, workers, and public health scientists for most of this century. Early use of lead arsenate insecticides in the tree fruit industry stimulated epidemiological research on pesticide applicators in the 1930s. The introduction of organophosphate insecticides and other modern pest control products in the 1940s and 1950s led to extensive workplace investigations designed to prevent pesticide poisonings. This research continues today, and the focus has expanded to include the families of agricultural workers and communities in farming regions. Periodic illness outbreaks, such as the acute poisoning of pesticide applicators by phosdrin, incidents related to pesticide drift, and carbon monoxide poisoning inside packing houses, maintain the public’s attention on farming as a hazardous industry. The role of pesticides and other agri-chemicals in producing chronic health effects remains a complex field of study, and the subject of much public debate. As one university extension agent pointed out, “Accidents make news and increase awareness, but pesticides go unnoticed or unknown. [Workers] don’t know [if] they have been exposed or [are] handling [them] wrong, [they become] sick later and don’t know the cause.” Research can provide a better understanding of the health hazards of these chemicals, which can lead to new methods for educating workers and the general public.

RESEARCH OPPORTUNITIES

• Improve chemical exposure monitoring through baseline testing
• Involve manufacturers in developing systems and programs
• Research adverse reactions to chemicals and gases in the agricultural industry and the appropriate personal protective equipment to guard against these exposures
• Address exposure assessment, biological markers, and general and long-term effects
• Document the need for chemical exposure awareness and the prevalence and specific use of agri-chemicals
• Explore engineering methods to reduce hazards or eliminate them by the use of less hazardous materials
• Perform genetic research to develop biological controls for insect and plant disease to reduce the amount of chemical handling and disposal
• Identify chemical exposure data specific to the Northwest region
• Investigate the extent of pesticide exposure from spray and drift
• Research take-home exposures
• Investigate cholinesterase levels
• Assess the impact of using expiration dates on agri-chemicals
• Investigate poisoning outbreaks

TRAINING OPPORTUNITIES

• Improve pesticide training
• Conduct chemical safety training
• Improve information dissemination concerning high-risk behaviors
• Employ stricter licensing requirements for applicators and mixer loaders
• Provide training on pesticide use reduction

ADDITIONAL INFORMATION

Keifer, MC, ed. Human Health Effects of Pesticides. Occupational Medicine State of the Art Reviews, Vol 12. Philadelphia: Hanley & Belfus, Inc., 1997.

Fenske RA, Simcox N. Agricultural workers. In: Occupational Health: Recognizing and Preventing Work-Related Disease, (Levy BS, Wegman DH, eds). Boston: Little, Brown and Co., 1995. pp. 665–683.

Fenske RA. Pesticide exposure assessment of workers and their families. In: Occupational Medicine State of the Art Reviews. (Keifer MC, ed). Philadelphia: Hanley & Belfus, Inc., 1997.

ExToxNet—Extension Toxicology Network at Oregon State University homepage: http://ace.orst.edu/info/extoxnet

National Pesticide Telecommunications Network: Oregon State University and the US Environmental Protection Agency homepage: http://ace.orst.edu/info/nptn

Washington State Pesticide homepage: http://pep.wsu.edu/

SPECIAL POPULATIONS AT RISK



Many types of people participate in Northwest farming. Occupational hazards are known to be distributed differentially across populations, and workers with specific biological, social, or economic characteristics are more likely to have increased risks of certain work-related diseases and injuries. Some of these populations have been undeserved in the past, such as migrant and seasonal workers and children of agricultural families. Particular concerns in farming include exposure to chemicals, traumatic injuries, substandard housing, and lack of adequate training, education, and skills. Loss of employment is a risk factor of special importance for the farm worker population. Research is needed to define the nature and magnitude of risks for well-defined subgroups within the worker population, and to develop appropriate intervention and communication strategies.

[NIOSH NORA: Special Populations at Risk]

IMPORTANCE

Participants frequently mentioned concern about the health and safety risks of special populations in Northwest agriculture. Issues related to migrant workers, Hispanics, and children extended across many research priority categories. For example, participants noted the importance of exposure to pesticides, and traumatic injury among children.

The needs and abilities of non-English speaking workers were raised, and in a few cases respondents specifically noted the importance of training for non-English-speaking pesticide workers. An extension agent noted that training methods should be improved for migrant workers. She stated that, in Idaho, migrant workers were at increased risk for injuries because they were not properly trained to handle equipment. In addition, because they were not from the region, migratory workers may not be aware of how best to maneuver farming machinery over different types of terrain.

The Northwest relies on a large seasonal and migratory worker population, primarily Hispanic, for agricultural activities. Farm workers in this region face a number of health and safety issues, which are compounded by low wages and the seasonal nature of agricultural work. Due to the dangers inherent in many agricultural jobs, farm workers are at risk for cumulative trauma, musculoskeletal problems, respiratory disease, dermatoses, and noise-induced hearing loss. Farm workers and their families are also at elevated risk for chemical exposures. Lack of adequate housing and sanitation facilities may exacerbate these health and safety problems.

Children who live on or near farms are also at risk. It is estimated that 300 children and adolescents die each year from farm injuries in the US, and that 23,500 suffer nonfatal trauma. A recent National Academy of Sciences report on the health and safety implications of child labor recommended that “current distinctions between hazardous orders [regulations] in agriculture and nonagricultural industries should be eliminated from child labor laws.” A broad coalition on childhood agricultural injuries has successfully raised this issue at the national level, and Congress recently appropriated funds to NIOSH for research and intervention aimed at injury prevention.

Children suffer injuries when performing agricultural work, and these injuries are often severe. Minors under the age of 15 employed on farms in Washington state were over represented in the number of claims filed by all minors.17 Reports from Oregon also reflect the dangerous nature of agriculture for children and youth as workers or bystanders on the farm. Between 1986 and 1995, agriculture ranked third, following retail and the service industry, in accepted disabling claims for workers aged 17 and under.18 Surveillance mechanisms for certain injuries are inadequate as children working on family farms and as short-term laborers may not be covered under workers’ compensation.

RESEARCH OPPORTUNITIES

• Investigate compliance with child labor laws
• Research children’s susceptibility to chemical exposures
• Study the effectiveness of disseminating information through Hispanic media
• Characterize the hazards of migrant labor
• Investigate the incidence of child injury

TRAINING OPPORTUNITIES

• Develop effective farming health and safety teaching tools for children with auditory, tactile, and visual materials and bring safe equipment operation instruction into junior high and high school classrooms
• Employ multilingual and culturally specific training methods through theater and non-formal education techniques to reach a non-English speaking audience

ADDITIONAL INFORMATION

National Research Council Committee on the Health and Safety Implications of Child Labor. Protecting Youth at Work. Washington, DC: National Academy Press, July 1998. Available on-line at http://www.nap.edu

Heyer N, Franklin G, Rivara FP, Parker P, Haug JA. Occupational injuries among minors doing farm work in Washington State: 1986–1989. Am J Public Health 82:557–560 (1992).

National Children’s Center for Rural and Agricultural Health and Safety homepage: http://www.marshfieldclinic.org/nfmc/pages/default.aspx?page=nccrahs_welcome/

National Committee for Childhood Agricultural Injury Prevention. Children and Agriculture: Opportunities for Safety and Health. Marshfield, WI: Marshfield Clinic, 1996.

National Children’s Center for Rural and Agricultural Health and Safety. North American Guidelines for Children’s Agricultural Tasks. Wisconsin: Marshfield Clinic (1999).

Rivara F. Fatal and nonfatal farm injuries to children and adolescents in the United States 1990–1993. Inj Prev 3:190–4 (1997).

US NIOSH. Injuries among Farm Workers in the United States, 1993. Washington, DC: National Institute for Occupational Safety and Health, 1997. Available on-line: http://www.cdc.gov/niosh/pdfs/97-115-a.pdf

National Center for Farmworker’s Health homepage: http://www.ncfh.org/

Migrant Clinicians Network homepage: http://migrantclinician.org/

National Center for Farmworkers’ Health homepage: http://www.ncfh.org/

SOCIAL AND ECONOMIC FOUNDATIONS OF WORKPLACE HEALTH AND SAFETY



Health protection in the workplace includes the provision of basic public health services, such as sound nutrition, clean water, adequate and safe housing, and access to health care. For some farm workers, however, the existence of these basic services cannot be taken for granted. Additional social and economic aspects of farm worker life that affect health include lack of sanitary facilities, poor prenatal care, lack of day-care facilities, and alcohol and drug use. Concerns for producers include economic pressure on farmers, production stress, fatigue induced by a mix of factors including short growing seasons, and fluctuating markets.

[NIOSH NORA: Not included in the NORA document]

IMPORTANCE

Workplace health and safety issues in farming are inextricably linked to broader social and economic factors, particularly for farm workers. A recent study conducted by the California Research Bureau for that state’s legislature identified ethnic diversity, low income, housing, sanitation, health care access, and education as key aspects of farm worker health. The report compared farm work with the other major occupational categories in the state, and noted that farming had the highest percentage of workers living below the poverty line, working the longest hours, and having the lowest proportion of health insurance coverage, and the lowest educational level. The report also included data on the implementation of the 1986 OSHA Sanitation Standard, indicating that about 60% of farms surveyed in California were out of compliance with the standard.¹⁹

In the Northwest, there has been recent focus on farm-worker housing and field sanitation, and several initiatives are underway to improve these basic needs. The US EPA Worker Protection Standard is now in effect, and is leading to more diligent efforts to reduce pesticide exposures. Research is needed to evaluate these efforts, and to identify effective means of improving public health services in rural communities.

Among farm operators, economic uncertainty and long working hours can produce stress. Stress has long been considered a “fact of life” in farming communities, but has more recently been recognized as an important risk factor for injuries and chronic diseases. New research has helped define the various components of farm stress, allowing the design of interventions. Further efforts in this area are likely to improve the quality of life for farmers and reduce the risks of injury and illness.

RESEARCH OPPORTUNITIES

• Investigate the costs and benefits of safety and health interventions
• Study stresses of farming life among farmers and farm families
• Assess the variation in health status among farm workers living in on- and offsite housing
• Investigate the impact of piece work vs. hourly pay on safety and health
• Determine the adequacy of day-care use in the farm-worker community

ADDITIONAL INFORMATION

Bugarin A, Lopez E. Farmworkers in California. Sacramento: California Research Bureau, 1998.

Washington State Department of Health. Common Sense and Science: New Directions in the Regulation of Temporary Worker Housing. Olympia, WA: Washington State Department of Health, 1996.

Elkind PD, Cody-Salter H. Farm stressors: the hazards of agrarian life. Ann of Ag and Env Med 1:23-27, 1994.

Kelsey T. Farm product prices and agricultural safety: connections and consequences. J Rural Health 8:143–146, 1992.

RISK COMMUNICATION BARRIERS



Many occupational and environmental health problems are characterized by substantial scientific uncertainty. Our understanding of disease in humans may be derived from animal models, or the duration and magnitude of exposures may not be well known. Under these circumstances, effective risk communication is particularly challenging. Some of the barriers to risk communication in Northwest farming include a lack of interest in health and safety issues among farmers and workers, and tension between producers and employees. Government programs have not always been effective in reaching the proper audiences, or in providing meaningful risk information to the community. Communication is difficult with a non-English-speaking workforce and among those with minimal education. Research is needed to better characterize these barriers, and to translate scientific discussions of risk into messages relevant to farming communities.

[NIOSH NORA: Not included in the NORA document]

IMPORTANCE

Producers, workers, and the general public receive many messages about health risks in farming. Public and private interest groups, government agencies, health-care providers, and the media are all sources of information. What information is essential? How can conflicting messages be resolved? Research over the past 15 years has demonstrated that effective risk communication is an important part of risk management, and without it even the most detailed and exhaustive risk assessments have little impact on public policy.

Participants in the Farm Summit and those interviewed by telephone were supportive of identifying risk communication as a key priority in farming. Most comments emphasized the problems with risk communication. In some cases, relatively small risks seem to be blown out of proportion, and communities may be alarmed unnecessarily. On the other hand, serious risks are often ignored either because of economic concerns or due to a sense of fatalism that can pervade farming and rural communities.

It was agreed that further efforts were needed to improve communication among scientists, educators, the farm community, and the general public about heath and safety issues in agriculture. Language and cultural and educational differences were identified as potential barriers in the farm worker population. Interpersonal relations were also viewed as crucial to effective communication. Consistent with evidence from numerous industries across the nation, participants raised concern about the lack of communication, animosity between employers and employees, and fear of losing one’s job for reporting health and safety violations.

Several extension agents noted the farming labor community’s lack of interest in agricultural health and safety information. A producer commented that many farmers and ranchers believe they know all about safety and are, therefore, not interested in the topic. A number of participants commented that the importance of safety information didn’t seem relevant until somebody close to them was killed or injured.

Some participants provided recommendations to improve risk communication. The information could be combined with topics of greater interest to farmers, managers, and labor, such as how to maintain, use, or make equipment. The training should be provided at the local level, as the intended audience wasn’t willing to travel very far. Since time was valuable and “people get tired of talkers,” bulletins and reading materials sent to the farmer’s home may have more of an effect than sponsoring safety meetings. Radio programs for migrant and seasonal labor workers was noted as an effective medium. A public agency representative recommended videos or training that would include testimonies of accident victims and their families.

RESEARCH OPPORTUNITIES

• Develop more effective training techniques, bilingual teaching and information, improved language training, and incorporate cultural differences
• Identify specific cultural differences and how they affect perception of risk
• Evaluate new teaching formats (such as Foto Novelas)
• Describe the farm worker population in terms of different ethnicities and languages
• Investigate the use of economic incentives to increase the number of workers willing to learn English
• Explore the impact of solid research, case studies, incentive programs, family members, and agricultural organizations on attitudes and behaviors
• Investigate the economic benefits of safety programs
• Examine farm workers’ fears about reporting incidents

ADDITIONAL INFORMATION

Oskam JB. Diffusion of agricultural health and safety information: a two part study of Oklahoma farmers and extension agricultural engineers. J of Applied Comm 79:13-24 (1995).

Pierson TG, Murphy DJ. Safety and health educational needs of agricultural education and industry professionals. J of Safety Research 2:103–116 (1996).

White K, Peterson T, Vallabhan S, Stephenson MT, Plugge C, Givens VK, Todd JD, Beckgtold MG, Hyde MK, Jarrett R. Preventing tractor-related injuries and deaths in rural populations: using a persuasive health message framework in formative evaluation research. The Quarterly of Community Health Education 13:219–251 (1992–93).

Tiner TL, Silberberg PG. An evaluation primer on health risk communication programs and outcomes. Washington DC: Department of Health and Human Services, 1997.

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