Surveillance of Hired Farm Worker Health and Occupational
Safety
Appendix D: Project Designs and Methods
Priority #1: Regional/Local Studies
Community-wide, "house-to-house" surveys
Get occupational information
Include "unconventional" settings and baseline data
Get cases not seeking medical care
Migrant health center/clinic-based
Computerized
Appropriate case-reporting mechanism - linked to action and
appropriate follow-up
Link local survey efforts with clinics for medical exam
component
Compare diagnoses to population baseline (e.g., thyroid
disease)
Health outcomes - associations with exposures
Causation
Acute vs. chronic conditions
Longitudinal studies
Multi-site studies
Need for control group
Use NIOSH Agricultural Safety and Health Centers to collect data
Collaborate with migrant health centers and community-based farm
worker organizations
Use lay health advisors/community members who have trust of farm
workers to gather data
Reach farm workers at health fairs that give free health services,
disease screening
Observe geographic/temporal differences
Measure extent to which workers' compensation data underestimates true
prevalence of specific conditions (e.g., eye problems)
Non-existent workers' compensation in states - publicize
differences for farm workers vs. other workers
Compare regional differences in workers' compensation
services
Explore effects of occupational medicine education courses (CMEs)
on worker participation in workers' compensation systems
Priority#2: National / International Studies
National baseline data needed
Create a National Agricultural Exposure Survey like the National
Occupational Health Survey (NOHS)
Assure representativeness of surveys
Observe geographic/temporal differences
Address unique living conditions (e.g., surveys done at
state-run labor camps only capture one portion of the farm worker
population)
Correlate exposure surveillance with illness data
Link exposure to outcome. At individual level (may be later
step)
Use standard instrument like Farm Family Health Hazard Survey
(FFHHS), National Health Information Survey (NHIS), and Hispanic
Health and Nutrition Examination Survey (HHANES)
Augment with information from lay health advisors/farm worker
interviews
Clinic-based research for all categories of hazardous exposures
Migrant health centers
Appropriate case-reporting mechanism - linked to action and
appropriate follow-up
Occupational clinics
Health outcomes - associations with exposures
Causation
Acute vs. chronic conditions
Longitudinal studies
Multi-site studies
Build on Department of Labor's National Agricultural Workers Survey
(NAWS)
Do occupational health supplement
Use to validate clinic-based surveillance, link with local
surveys
Use NIOSH Agricultural Safety and Health Centers to collect data
Collaborate with migrant health centers and community-based farm
worker organizations.
Measure extent to which workers' compensation data underestimate true
prevalence of specific conditions (e.g., eye problems)
Prevalence of complaint at camps vs. clinic prevalence
Health surveillance on workers exposed to newly introduced
agricultural products and new applications
Clinic surveillance and case descriptions
Symptom incidence and prevalence
Preventive studies directed at new agents
Priority #3: Special Populations
Two items received an equal rank.
Pregnant Women Hired Farm Workers
Pesticide exposures
Comments
Vulnerability to injuries especially in 2nd and
3rd trimesters of pregnancy
Border issues/pesticides used in each country
Effect of work on miscarriages
Effect of chemicals on pregnancy
Women of childbearing age
Recovery from injuries vs. men
Effect of work on miscarriages
Effect of chemicals on pregnancy
Access to contraception
Children
Injuries
Cancer
Day care availability
Greenhouse workers
Disabled workers
Prevalence
"Job" when no longer able to do agricultural work
Tobacco workers - green tobacco sickness
Exposure to pesticides
Green tobacco illness
Accidents in the fields
Crab workers
Effectiveness of interventions
Orchard workers
Injuries with ladders
Exposure from foliage
Appropriate Data Sources for Farm Worker Surveillance and Research
Projects
NIOSH SENSOR (Sentinel Event Notification System for Occupational
Risks) data from California, Oregon, Texas, and New York regarding
pesticide poisonings
NIOSH Agricultural Safety and Health Centers
Bureau of Labor Statistics Survey
Workers' Compensation Insurance national compilation of data
Agricultural Census of 1992
Data for US and by state
Reports analyzing data from one or more years
National Agricultural Workers Survey (NAWS) - US Dept of Labor
New quarterly fact sheets
Reports analyzing data from one or more years
OSHA data on migrant housing and field sanitation inspections and
enforcement actions
Hospital discharge data
Death Certificates
Newsletters
RCAP/MESA newsletter
Migrant Health Newsline
Migrant Clinicians Network Streamline
University of California at Davis Agricultural Health and Safety
Center
Cancer registries
Birth defect registries
EPA Pesticide Farm Safety Center Final Report (1988)
Lay health worker/promotores
US Department of Agriculture/Easter Seal Society Agribility
data
Clinic-based surveillance - migrant health centers, occupational
clinics
Household surveys, including "unconventional" settings
Emergency rooms
EPA data (reports)
Poison control centers
State-based programs
California pesticide use reports
Department of Agriculture
Health Department
Field sanitation inspections
Housing inspections
Workers' Compensation Insurance
Rehabilitation Services
Compendium of national and state farm worker laws by Motivation,
Education, and Training (MET) in Texas - published 1988
Berkeley Planning Associates study of farm worker
rehabilitation
Limitations of These Data Sources
Do not provide adequate information on farm workers
Prevalence of exposure and/or illness in migrant population
Distribution of/by work tasks
Need for data in special populations, e.g., pregnant women
Incomplete or poor data may be worse than none (e.g., may look as
though no problem exists)
Do not address problems related to agriculture
Exclude small farms
Need to address the way exposed: skin, seasonal
Need NIOSH Recommended Exposure Levels (RELs) for pesticides
Sampling methods miss people
NAWS done only three times per season and misses geographic
areas
1992 Census of Agriculture is self-reported data, excludes crew
leaders, etc.
This document is in the public domain and may be freely
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NOTE: This document is provided for historical purposes only.