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Surveillance of Hired Farm Worker Health and Occupational Safety

Executive Summary

Since its inception in 1970, the National Institute for Occupational Safety and Health (NIOSH) has sought to improve the health and safety of all United States workers through training, education, and research. Until 1990, NIOSH primarily targeted the occupational health and safety status of industrial workers. That year, however, the efforts of Senator Tom Harkin and family farm advocates produced the congressionally mandated NIOSH Agricultural Initiative. With steady support from Congress, NIOSH was able to place agriculture among its top surveillance and research priorities.

While this initiative succeeded in drawing attention to the many dangers that confront agricultural workers, the work largely focused on the traditional family farm. Recognizing that its surveillance and research projects had neglected other important members of the agricultural labor force such as hired farm workers, NIOSH expanded the scope of its agricultural initiative to include this distinct population. To this end, in May 1995, NIOSH Epidemiologist Lorraine Cameron convened a work group consisting of experts in the areas of public policy, farm worker advocacy, and occupational health to assist NIOSH in developing a prioritized set of objectives for the surveillance of hired farm worker occupational safety and health.

This thirteen member ad hoc committee began by determining the obstacles that have hampered previous efforts. They arrived at six:

• worker factors, such as immigration status;
• farm owner and labor contractor opposition to government regulations;
• migrant clinic and clinician factors, such as a lack of training in occupational medicine;
• weaknesses in the Workers' Compensation Insurance system;
• limitations of current and previously used surveillance techniques;
• the political climate toward agricultural labor.

The work group then devised a set of possible solutions for overcoming these obstacles. These proposals included the use of lay health workers, recruited from the hired farm worker population, to bridge the language and cultural gaps separating hired farm workers from those interested in monitoring their health status; increased support for organized labor; and greater enforcement of federal and state regulations.

The committee then turned its attention toward a discussion of topics central in the surveillance of the health status of hired farm workers. The group considered important health outcomes in the hired farm worker community, for example, back injuries and traumatic accidents; hazardous workplace exposures, such as pesticides; systems for measuring the prevalence of these outcomes, such as Workers' Compensation Insurance; and interventions, which could be evaluated for their effectiveness, such as Worker Protection Standard training.

From this exchange of ideas emerged a consensus regarding health issues and work exposures for surveillance and research. For surveillance, the work group identified ten occupational health priorities and ranked them in order of their importance:

• workplace ergonomic conditions and musculoskeletal injuries,
• pesticides,
• traumatic injuries,
• respiratory diseases,
• water quality,
• infectious diseases,
• cancer,
• eye conditions,
• mental health.

Similarly, for research, the committee identified seven occupational health priorities and ranked them in order of their importance:

• pesticides,
• ergonomic and musculoskeletal conditions,
• injuries,
• effect of protective measures,
• cancer,
• identification of control or comparison populations,
• mental health.

Lastly, the committee addressed project design and methods for conducting surveillance; useful data sources and documents for future research and surveillance projects; additional means for procuring funding and increasing its distribution among those concerned with hired farm worker health and safety; and efforts for increased collaboration between governmental agencies and community based organizations such as hired farm worker interest groups.

This report summarizes those factors and recommended priorities originating from the Spring 1995 meeting. It is intended to serve as a guide for NIOSH and for other government agencies concerned with agriculture and with the health and well-being of its hired labor force.

This document is in the public domain and may be freely copied or reprinted.

NOTE: This document is provided for historical purposes only.

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