SUMMARY : CASE 191-002-01
A cantaloupe picker collapsed and died of heat stroke after four hours of work. The summer cantaloupe harvest is one of the hardest jobs in farming. Workers stoop to pick the cantaloupes and put them in bags they carry on their shoulders. When the bags are full and weigh about 50 pounds workers carry them to a truck. Crews are paid by the number of trucks they load in a day, and so workers do not stop for breaks.
The worker began picking at 6:00 a.m. At 9:00 a.m. he complained of a headache. He worked for another hour, and then his crew took a bus to another field. On the bus he began to pant, and felt anxious and sick to his stomach. The foreman stopped the bus and called an ambulance. The worker was taken to the hospital and treated, but died 36 hours later of heat stroke.
How could this death have been prevented?
On July 25, 1991 NURSE staff received a report from a local community program that a 25 year-old Hispanic male had collapsed after picking cantaloupes. The local coroner informed NURSE staff that the picker had died from complications of heat stroke, or hyperthermia. A brother of the deceased picker, who had been working with him that day, took the body home to Mexico to be buried. A nurse from the NURSE Project traced the brother when he returned from Mexico and interviewed him on March 9, 1992. On February 6, 1992 the Senior Safety Engineer conducted an on-site investigation and discussed the incident with the safety director of the farm company. NURSE staff also reviewed the emergency medical service run sheets, the hospital records, and the coroner's records. The employer notified the local California Occupational Safety and Health Administration (Cal/OSHA) compliance office, but Cal/OSHA did not conduct an investigation.
The cantaloupe field where the deceased picker was working was owned by a farming corporation which employs, through a separate harvesting company, approximately 320 employees during the peak harvest season. The corporation has a full-time safety director. Field foremen of the company are trained at the beginning of the season using the safety training outline in the company Injury and Illness Prevention Program. Employees are trained periodically.
The NURSE Senior Safety Engineer reviewed the company safety program and noted that it addressed all seven points as required by Title 8 California Code of Regulations 3203 - Injury and Illness Prevention Program. (As of July 1, 1991 the State of California requires all employers to have a written seven point injury prevention program: designated safety person responsible for implementing the program; mode for ensuring employee compliance; hazard communication; hazard evaluation through periodic inspections; injury investigation procedures; intervention process for correcting hazards; and a written health and safety program.)
Cantaloupe harvesting is one of the most strenuous jobs in agriculture. The workers stoop over to pick the cantaloupes off vines at ground level, and place the melons in a bag. They carry the bag over their shoulder until it is full (weighing about fifty pounds) and then carry the bag to a truck that is moving through the field. Cantaloupe pickers are paid on a piece rate basis, calculated by how many trucks a crew loads in a day. After the crews begin working they generally continue until mid-day without scheduled breaks. When the trucks reach the end of a row there is a 1-2 minute interval while they turn around, and the workers use this opportunity to drink water while they wait for the truck to align with a new row. Drinking water is available on the cantaloupe trucks and is also carried on the buses used to transport workers to different fields.
The cantaloupe picker was employed as part of a 10 to 15 member crew, and had three years of experience. As part of a scheduled weekly training he had been trained the day before on proper lifting and carrying techniques to prevent back injury. However, no training on heat stroke prevention was given. The worker was moderately obese, at 5'5" and over 200 pounds. The ambient temperature during the initial part of the work day was 70 degrees F with a relative humidity of 70-80%, the noon time reading was 95 degrees F and the high for this day was 101 degrees F with a relative humidity of approximately 25% at 4 p.m. The high temperature for the previous day was 99 degrees F with a relative humidity of 22% at 4 p.m.
The worker began to pick and load cantaloupes in the field at 6:00 a.m. At approximately 9:00 a.m. he told the field foreman that he had a headache and was not feeling well. He was perspiring heavily and asked for an aspirin, but continued to work in the field for another hour before walking to the bus with the rest of the crew in order to be transported to a new field. While traveling on the bus the worker became extremely ill: anxious, nauseated, and short of breath. At 10:40 a.m. the bus was stopped near a county road maintenance crew, who were able to call the local emergency medical service (EMS). The EMS dispatcher gave instructions to place the worker in the shade of a tree. One of his brothers (a co-worker) stayed with him until the EMS arrived, approximately 20 minutes after they were called.
When the EMS paramedics arrived they found the individual disoriented, hyperventilating, and vomiting. They established an IV of Lactated Ringers solution with valium to provide him with fluid replacement. He was transported to a level 2 trauma center, a fifty minute journey, and arrived almost one and a half hours after the EMS was called. His body temperature was 105.6 degrees F when he arrived at the emergency department. He was admitted to the intensive care unit of the level 2 trauma center in poor condition with an admission diagnosis of heat stroke with metabolic encephalopathy and seizure disorder. He was placed on a ventilator but developed renal failure and pneumonia and died 36 hours after the EMS was first called.
The cause of death listed by the coroner was complications of hyperthermia with acute bronchopneumonia.PREVENTION STRATEGIES
For further information concerning this incident or other agriculture-related injuries, please contact:NURSE Project
2151 Berkeley Way, Annex 11
Berkeley, California 94704
1111 Fulton Mall, Suite 212
Fresno, California 93721
1000 South Main St., Suite 306
Salinas, California 93901
Publication #: CDHS(COHP)-FI-92-005-07
This document was extracted from a series of the Nurses Using Rural Sentinal Events (NURSE) project, conducted by the California Occupational Health Program of the California Department of Health Services, in conjunction with the National Institute for Occupational Safety and Health. Publication date: May 1992.
The NURSE (Nurses Using Rural Sentinel Events) project is conducted by the California Occupational Health Program of the California Department of Health Services, in conjunction with the National Institute for Occupational Safety and Health. The program's goal is to prevent occupational injuries associated with agriculture. Injuries are reported by hospitals, emergency medical services, clinics, medical examiners, and coroners. Selected cases are followed up by conducting interviews of injured workers, co-workers, employers, and others involved in the incident. An on-site safety investigation is also conducted. These investigations provide detailed information on the worker, the work environment, and the potential risk factors resulting in the injury. Each investigation concludes with specific recommendations designed to prevent injuries, for the use of employers, workers, and others concerned about health and safety in agriculture.
Disclaimer and Reproduction Information: Information in NASD does not represent NIOSH policy. Information included in NASD appears by permission of the author and/or copyright holder. More