California Department of Health Services
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SUMMARY : CASES
291-003-01, 291-003-02, 291-009- 01, 291-009-02, 291-009-03
Lightning
strikes killed two farm workers who were picking and hoeing
lettuce during a thunderstorm. They worked on crews about
fifteen miles apart. One crew was leaving the field because
of the lightning, when one of the last workers out was struck
by a lightning bolt. He died immediately of a heart attack.
The
second crew had taken shelter in a bus during the storm, but
when the rain stopped they returned to the field. A worker
was bent over hoeing lettuce when he was struck. The lightning
strikes continued, and paramedics had trouble reaching the
worker and getting him to the ambulance. The worker died in
the hospital from burns.
How
could these deaths have been prevented?
- The
foremen should have stopped work during a lightning storm
which spread over many miles. Both foremen attempted to
work during some part of the storm.
- One
person cannot judge dangerous weather conditions. Foremen
should use portable weather radios or the cable weather
channel.
- Both
workers had immediate heart attacks when struck by lightning.
Every field work crew should have one person certified in
Cardiopulmonary Resuscitation (CPR).
BACKGROUND
NURSE
staff identified two lightning-related deaths on two different
lettuce farms in California through newspaper and weather
reports in September, 1991. The two deaths occurred in two
separate cloud to ground lightning strikes in locations about
15 miles apart. The strikes happened about 35 minutes apart
during a thunderstorm in which over 2,000 strikes to ground,
during a 24 hour period, were recorded by the local gas and
electric company in the eastern edge of a valley surrounded
by low mountains (see attached maps). Lettuce field workers
(pickers and hoers) working for two different employers (both
farm labor contractors) were involved in these two incidents.
A Senior Safety Engineer, a nurse, and an epidemiologist from
the NURSE project discussed the incident with one of the farm
labor contractors on February 7, 1992. The other farm labor
contractor declined to discuss the incident due to pending
litigation. The California Occupational Safety and Health
Administration (Cal/OSHA) was notified of both deaths by the
local emergency medical services who responded. Cal/OSHA conducted
investigations of both fatalities.
Farm
labor contractors are used by some farm owners and operators
of large corporate farms in California to recruit, train and
manage workers. Information on one farm labor contractor's
safety program (Incident 1) was reviewed by Cal/OSHA on September
9, 1991 and was found to be in compliance with 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 health and safety program.) This
farm labor contractor employs approximately 110 casual workers
and 100 seasonal workers.
INCIDENT 1.
On September
6, 1991 at approximately 8:20 a.m., during a period of rain
accompanied by occasional lightning, there was a lightning
strike in a lettuce field. At this time most of the workers
had already left the field at the request of the foreman due
to the weather conditions (rain and lightning) and because
the field was extremely muddy. However, three workers were
still in the process of leaving the field when one worker
was struck by lightning; co-workers noted he was unresponsive
after being struck. The local emergency medical services responded
to the 911 call from the field crew.
Upon
arrival (approximately 20 minutes after the injury occurred)
they found a 22 year old Hispanic male in cardiac arrest after
being struck by a lightning bolt which hit the left side of
his head, as indicated by singed hair, second degree burns
extending from the top of his head to his ear, and a focal
third degree burn which penetrated his top left ear, passed
through his body, and exited at the midline of his lower abdomen
as indicated by a half inch diameter zone of third degree
burns and charring of the skin. The fire department and county
EMS paramedics initiated CPR, and transported him (approximately
26 minutes later due to a lengthy extrication) to the local
emergency department where he was pronounced dead. Two female
workers who were walking beside him were knocked down by the
lightning. They were transported by EMS and treated at the
local emergency department. They were not admitted, due to
the minor nature of their injuries.
The
cause of death reported by the coroner was cardiac arrest
secondary to lightning strike.
INCIDENT 2.
On September
6, 1991 at approximately 7:20 a.m., during a period of rain
accompanied by lightning, there was a lightning strike in
a lettuce field where workers were hoeing fields to remove
weeds from between the lettuce rows. The hoeing crews had
initially been called out of the fields by the foreman until
the rain stopped. At this time the crews put on rain gear
and went back out and resumed hoeing. The fatally injured
worker (who was working for the first time for this farm labor
contractor) was bent over hoeing with the crest of his body
about four feet above the ground. He was struck by lightning
as indicated by extensive first and second degree burns over
the right side of his face, neck, front and back chest, front
and back legs covering approximately 50-60% of his total body
surface. (Another worker was injured when he was struck by
the hoe used by the victim which was involuntarily thrown
from the victim's hands during the lightning strike. He was
transported to the emergency department of a local hospital,
treated, and released.) Upon arrival of the county EMS paramedics
which responded to a 911 call (within 10 minutes of injury)
from the field crew, they noted a 20 year old Hispanic male
who was in cardiac arrest. Due to the continuing lightning
strikes in the field, the extrication of the injured worker
was lengthy. He was initially transported (undergoing CPR
enroute) to a local hospital emergency department where he
received fluid resuscitation, was stabilized and was subsequently
transported via ambulance and admitted to the burn unit of
the regional trauma center in the neighboring county. He then
went into cardiac arrest but was successfully resuscitated.
During an exploratory laparotomy he went into cardiac arrest
again, and was successfully resuscitated again. He was then
placed in the burn unit of the trauma center where he suffered
a third cardiac arrest from which he was not resuscitated
successfully.
The
cause of death as reported by the coroner was burns over 50-60%
of body surface due to lightning strikes accompanied by extensive
hemorrhagic myocardial damage, focal intracranial hemorrhage,
massive congestion and edema of his lungs and brain, and visceral
organ congestion.
PREVENTION STRATEGIES
- Employers
should not permit workers to be exposed to a hazardous work
environment. These incidents took place during an extensive
thunderstorm with approximately 2,000 lightning strikes
recorded. This is a highly unusual occurrence in this geographic
location and should have alerted employers that workers
were in a dangerous work environment. Both foremen were
aware of the lightning -- in one incident the crew was leaving
the field and in the other the crew had initially been removed
from the field but was subsequently sent back to complete
their work. Employers should ensure that there is no lightning
in the vicinity of the fields before they allow workers
to continue working or allow them back into the field. One
farm labor contractor has subsequently initiated the policy
that all workers must leave the field whenever it is raining
regardless of whether there is lightning in the vicinity.
If this policy had been present prior to this incident,
the death of the worker would not have occurred.
- Foremen
are responsible for the safety of their work crews and for
obtaining information to assess hazards. Because foremen
may not have sufficient information based on their observation
only, it may be necessary to have additional information
from a weather monitoring station to provide information
on hazardous weather conditions. At the time of these incidents
a special weather statement had been issued which emphasized
lightning hazards and to exercise caution. If the farm labor
contractors or the foremen had checked the weather forecast
by using a portable weather radio or listening to the cable
weather channel they would have known there was imminent
danger to the farm workers. Employers could also verify
that conditions are safe by either calling the National
Oceanic Atmospheric Administration or another lightning
strike monitoring station (as maintained by the gas and
electric company) to verify that the storm has passed.
- There
should always be a person certified in Cardiopulmonary Resuscitation
(CPR) on a field work team. Farm workers may be working
in remote work sites in which rapid access to emergency
medical services may not be possible; therefore, it is important
that initial emergency medical care be available on-site.
In the first incident the paramedic crews had to use a four
wheel drive vehicle to reach the victim due to muddy field
conditions. In this first incident the worker died from
cardiac arrest; if he had received CPR from other workers
at the scene immediately after his heart stopped, the probability
for successful resuscitation could have been increased*.
* California Code of Regulations T8 3440 (subparagraph b)
requires that in a remote work location, 10-15 minutes from
medical help, one member of the crew should have First Aid
training equivalent to Red Cross certification.
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-92-005-04
,
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.
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