California Department of Health Services
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SUMMARY : CASE
192-163-01
A farm
labor contractor was hired to pick a plum orchard as quickly
as possible. The field supervisor was in such a hurry that
he skipped the usual morning safety meeting and sent the crew
straight to work. The supervisor then left the field, without
watching to see if the workers were picking safely.
Plums
are often picked from ten foot ladders which weigh about 25
pounds. Each worker moves his ladder from place to place under
a tree to easily reach plums. For one worker, this was his
first day on the job. Standing on one of the top steps of
a ladder, he reached for some plums that were beyond his reach.
He lost his balance and fell off the ladder, hitting the ground
eight feet below. The ladder fell on top of him and broke
his ankle.
The
only person trained in first aid was the field supervisor,
who had left the orchard. The foreman put the injured worker
in the back of his pickup truck and drove him to the hospital.
At the hospital, the worker's ankle was put in a splint. He
was still wearing the splint and out of work at the time of
this investigation.
How
could this injury have been prevented?
- Train
all employees in work methods, whether full-time or seasonal.
Do not allow workers to begin work without any safety training.
- All
workers, including supervisors and foremen, should be trained
in how to handle emergency situations; for example, calling
911 instead of moving the injured person.
BACKGROUND
On June
26, 1992, NURSE staff identified an injury in a plum orchard
while reviewing records at a a Level 1 Regional Trauma Center.
A 65 year-old Hispanic male plum picker broke his ankle on
June 16, 1992 when he fell approximately eight feet from his
ladder to the ground. The plum farm employs approximately
170 employees, of whom 100 are seasonal (working 13-37 weeks
per year). This worker had been hired by a farm labor contractor
to pick plums during the harvest season. Instead of hiring
farm laborers directly, some farm operators use farm labor
contractors to recruit, train, and manage their seasonal workers.
The injured worker had picked fruit in California before,
but had been living in Mexico for the past ten years. He had
only recently returned to California, and had been working
(along with his son) for the farm labor contractor for less
than two hours before he was injured.
A nurse
from the NURSE project interviewed the injured plum picker
on July 9, 1992. The NURSE Senior Safety Engineer discussed
the incident with the farm labor contractor -- the worker's
employer -- at the scene of the injury on July 21, 1992.
The
California Occupational Safety and Health Administration (Cal/OSHA)
was not notified and did not investigate the incident.
The
farm labor contractor involved in this incident used a safety
program that was prepared by an occupational safety consulting
company. The Senior Safety Engineer reviewed the written program,
and noted that, although brief, it addressed all seven points
included in the 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: 1. designated safety
person responsible for implementing the program; 2. mode for
ensuring employee compliance; 3. hazard communication; 4.
hazard evaluation through periodic inspections; 5. injury
investigation procedures; 6. intervention process for correcting
hazards; and 7. a health and safety program.)
According
to the farm labor contractor, the farm owner had requested
that the plums be harvested quickly because of the current
price of fruit. Because the crew had to work fast, the field
supervisor (a brother of the farm labor contractor) did not
hold the usual tailgate safety meeting with the crew before
beginning work on the day of the incident. Tailgate safety
meetings are brief talks on safety practices given by the
foreman or supervisor at the worksite before the start of
the workday. Instead of watching the employees' work methods
at the start of the workday as he usually did, the field supervisor
left the field. The Senior Safety Engineer noted that there
were records of safety meetings for the picking crews on days
before and after this incident, indicating that tailgate safety
meetings were usually conducted.
INCIDENT
On June
16, 1992, at approximately 7:00 a.m., a crew was picking plums
in a plum orchard. Plums are picked from ladders designed
for picking fruit, consisting of a set of ladder steps and
a single support pole. The trees are picked by two workers
moving down adjoining rows, picking the fruit from opposite
sides of the same tree. Each worker moves his ladder from
place to place under the tree to easily reach all the plums.
Even though the workers were being paid by the hour and not
by the amount of fruit picked, they were working rapidly because
the farmer had requested that the plums be picked quickly.
The
plum picker was standing on a ladder picking plums. His ladder
was ten feet high and weighed approximately 25 pounds. The
picker was standing on the step near the top of the ladder
when he reached his arm out to pick a plum that was not within
easy reach. He lost his balance and fell off the ladder onto
the plowed dirt between the plum trees. He landed on his right
side. The metal ladder fell on top of him, landing on his
left ankle. He felt a severe pain in his ankle and could not
stand up.
The
injured plum picker was diabetic and had a history of high
blood pressure. His fall may have been partly due to dizziness
or other factors resulting from his medical condition.
The
field supervisor was trained in first aid and cardiopulmonary
resuscitation (CPR), but still had not returned to the field
at the time of the incident. The foreman, who was not trained
in first aid and CPR, picked the worker up, placed him in
the back of his pickup truck and drove him to the Level 1
Trauma Center (a county hospital), a journey of about 40 minutes.
The worker arrived at the Trauma Center emergency department
at 7:57 a.m. and was seen by a physician at 9:20 a.m.
At the
Trauma Center he was treated for a fracture in three places
of the tibia and fibula (the lower leg bones) at the ankle.
His left leg was splinted and the worker was discharged home
at 11:45 a.m. At the time of the NURSE interview on July 9,
1992, the worker was still in a splint, resting at home, and
being treated as an outpatient at the orthopedic clinic.
PREVENTION STRATEGIES
- Employers
should provide adequate training of seasonal employees.
This worker had been hired only a few hours before his injury.
In an effort to save time that morning, the farm labor contractor
had not conducted the usual tailgate safety meeting. Therefore,
the plum picker had no safety training in handling the ladder
or picking plums. If he had been trained, he might have
moved his ladder within easy reach of the plums, instead
of trying to reach them from his current ladder position.
- Every
field work crew should have a person certified in first
aid and CPR, and who is always present at the worksite (Title
8 California Code of Regulations 3400 (b): "In the absence
of an infirmary, clinic or hospital, in near proximity to
the workplace...a person or persons shall be adequately
trained to render first aid.") In this incident, the field
supervisor was certified but not present on the farm. If
he had been present, the risk of complications from the
injury could have been reduced. A person trained in first
aid might also have realized the potential seriousness of
injury to a 65 year-old man (who had diabetes and a history
of high blood pressure), and made sure that the Emergency
Medical Services (EMS) were called.
- Work
crews should have a cellular phone or radio available in
vehicles to contact the Emergency Medical Services (EMS).
In this incident, the foreman should have called 911 before
moving the injured worker. Because the worker did not receive
appropriate first aid in the field, he was at greater risk
of increased pain and complications. If 911 had been called,
his leg would have been splinted by trained EMS personnel
at the scene of the injury, thereby stabilizing him before
transport to the hospital. EMS would also have evaluated
other threatening medical conditions which might have been
related to his fall.
- Whether
or not an injury has occurred, no worker should be transported
in the back of a pickup truck. This places the worker at
risk of serious injury or death in the event of a collision
or rollover of the pickup truck. If the foreman had called
911 and allowed EMS to transport the plum picker, he would
not have exposed the worker to the risk of further serious
injury.
- Employers
should require field supervisors to closely monitor all
workers as they begin each new workday. Supervisors should
identify workers who need further training, or who will
not be able to complete the work tasks safely. If the crew
supervisor had observed that the plum picker was not moving
his ladder often enough to easily reach the plums, he could
have instructed the worker in safe work methods. This could
have prevented the plum picker from overextending and trying
to reach plums which were too far away, resulting in him
losing his balance and falling off the ladder.
FURTHER INFORMATION
For further
information concerning this incident or other agriculture-related
injuries, please contact:
NURSE
Project
California Occupational Health Program
Berkeley office:
2151 Berkeley Way, Annex 11
Berkeley, California 94704
(510) 849-5150
Fresno
office:
1111 Fulton Mall, Suite 212
Fresno, California 93721
(209) 233-1267
Salinas
office:
1000 South Main St., Suite 306
Salinas, California 93901
(408) 757-2892
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
NASD Review: 04/2002
This
document, CDHS(COHP)-FI-92-005-18,
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: October 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.
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