Occupational behaviors and farmworkers' pesticide exposure: findings from a study in Monterey County, California

Mixed-Methods Assessment of Farmworkers' Perceptions of Workplace Compliance with Worker Protection Standards and Implications for Risk Perceptions and Protective Behaviors

INTRODUCTION

The Environmental Protection Agency (EPA)'s Worker Protection Standards is the primary set of legislation aimed at protecting farmworkers from occupational pesticide exposure in the United States. Previous studies suggest that worker adoption of Pesticide Protective Behaviors (PPBs) promoted by WPS is associated with lower urinary pesticide concentrations. However, adoption of PPBs is often outside of the control of individual farmworkers and dependent on workplace factors such as employer provisioning of Personal Protective Equipment (PPE) and access to trainings/resources.

METHODS

We conducted a mixed-method study including urinary pesticide biomonitoring, surveys, and interviews with 62 Latinx farmworkers in southwestern Idaho from April to July 2022. We integrated findings across the various data sources to identify emergent themes relating to farmworkers' perceptions of workplace compliance with WPS and potential implications for their pesticide risk perceptions, protective behaviors, and urinary pesticide concentrations.

RESULTS

Participants reported some indications of poor workplace compliance with WPS regulations, notably inconsistent access to clean handwashing stations and notification of pesticide applications. Some farmworkers, particularly pesticide applicators, viewed herbicides to be categorically safer than other classes of pesticides such as insecticides; these perceptions appeared to influence protective behaviors, such as the relatively low use of PPE while applying herbicides. These findings are underscored by the higher concentrations of biomarkers of herbicides, but not insecticides, among pesticide applicators compared with non-applicators (e.g. median 2,4-D concentrations = 1.40 µg/L among applicators and 0.69 µg/L among non-applicators). Participants further reported concerns regarding the inadequacy of pesticide safety training, pesticide drift, and the lack of communication regarding pesticide applications on and near fields where they are working.

DISCUSSION

Participants' perceptions that herbicides are categorically safer than other pesticide classes is in direct conflict with WPS training, raising concerns about discrepancies between WPS instruction and other on-the-job training, as well as the inadequate provisioning of PPE during the application of certain pesticides. Our findings also suggest that current WPS regulations may not sufficiently address farmworkers' concerns, particularly in regard to pesticide drift.

Examination of urinary pesticide concentrations, protective behaviors, and risk perceptions among Latino and Latina farmworkers in Southwestern Idaho

INTRODUCTION

Studies have documented high levels of pesticide exposure among men farmworkers; however, few have examined exposures or the experiences of women farmworkers. Data gaps also exist regarding farmworkers' perceived risk and control related to pesticides, information that is critical to develop protective interventions.

OBJECTIVE

We aimed to compare urinary pesticide biomarker concentrations between Latino and Latina farmworkers and examine associations with occupational characteristics, risk perceptions, perceived control, and protective behaviors.

METHODS

We enrolled a convenience sample of 62 farmworkers (30 men and 32 women) during the pesticide spray season from April-July 2022 in southwestern Idaho. Participants were asked to complete two visits within a seven-day period; at each visit, we collected a urine sample and administered a questionnaire assessing demographic and occupational information. Urine samples were composited and analyzed for 17 biomarkers of herbicides and of organophosphate (OP) and pyrethroid insecticides.

RESULTS

Ten pesticide biomarkers (TCPy, MDA, PNP, 3-PBA, 4-F-3-PBA, cis- and trans-DCCA, 2,4-D, Glyphosate, AMPA) were detected in >80% of samples. Men and women had similar urinary biomarker concentrations (p = 0.19-0.94); however, women worked significantly fewer hours than men (p = 0.01), wore similar or greater levels of Personal Protective Equipment (PPE), and were slightly more likely to report having experienced an Acute Pesticide Poisoning (26% of women vs. 14% of men; p = 0.25). We observed inconsistencies in risk perceptions, perceived control, and protective behaviors among men.

DISCUSSION

Our study is one the first to examine pesticide exposure and risk perceptions among a cohort of farmworkers balanced on gender. Taken with previous findings, our results suggest that factors such as job tasks, biological susceptibility, or access to trainings and protective equipment might uniquely impact women farmworkers' exposure and/or vulnerability to pesticides. Women represent an increasing proportion of the agricultural workforce, and larger studies are needed to disentangle these findings.

Urinary dialkylphosphate metabolites in the assessment of exposure to organophosphate pesticides: from 2000 to 2022

The general population and workers are exposed to organophosphate insecticides, one of the leading chemical classes of pesticides used in rural and urban areas, in the control of arboviruses and agriculture. These pesticides cause environmental/occupational exposure and associated risks to human and environmental health. The objective of this study was to carry out an integrative review of epidemiological studies that identified and quantified dialkylphosphate metabolites in the urine of exposed populations, focusing on the vector control workers, discussing the application and the results found. Searches utilized the Pubmed, Scielo, and the Brazilian Digital Library of Theses and Dissertations (BDTD) databases between 2000 and 2021. From the 194 selected studies, 75 (39%) were with children/adolescents, 48 (24%) with rural workers, 36 (19%) with the general population, 27 (14%) with pregnant women, and 9 (4%) with vector control workers. The total dialkylphosphate concentrations found in the occupationally exposed population were higher than in the general population. Studies demonstrate that dialkylphosphates are sensitive and representative exposure biomarkers for environmental and occupational organophosphate exposure. The work revealed a lack of studies with vector control workers and a lack of studies in developing countries.

Preventive Measures and Hygiene Habits of Apple Producers in the Prespa Region

Background

Agriculture is one of the most dangerous industries, both for the employees in that sector and for their families and the environment. The use of personal protective preventive measures and the maintenance of good hygienic practices are the basis for healthy production and healthy workers. The safety and hygiene of food products should be present during all stages of production.

Objectives

The study aimed to assess the use of personal protective equipment (PPE) by apple growers during agricultural procedures as well as the hygiene habits of agricultural workers.

Subjects and Methods

A cross-sectional study was conducted including 101 farmers from the Prespa region in the Republic of North Macedonia by using a questionnaire with 34 questions. The questions were formulated in order to give us an insight into the protective preventive measures undertaken at work by apple producers and their hygiene.

Results

The study included 101 apple growers from the Prespa region. Wearing a completely tidy special PPE when using pesticides was registered in 78.2% of farmers, and when lawn mowing in 42.5%. 16% of the surveyed farmers during agricultural activities did not always wash their hands after going to the toilet, and almost 30% of them did not use soap when washing their hands.

Conclusion

There is inadequate hygiene practice/personal hygiene during agricultural activities. In addition, the proper use of PPE is not at a satisfactory level and poses a risk to the health of apple growers.

Pesticides and environmental injustice in the USA: root causes, current regulatory reinforcement and a path forward

Many environmental pollutants are known to have disproportionate effects on Black, Indigenous and People of Color (BIPOC) as well as communities of low-income and wealth. The reasons for these disproportionate effects are complex and involve hundreds of years of systematic oppression kept in place through structural racism and classism in the USA. Here we analyze the available literature and existing datasets to determine the extent to which disparities in exposure and harm exist for one of the most widespread pollutants in the world – pesticides. Our objective was to identify and discuss not only the historical injustices that have led to these disparities, but also the current laws, policies and regulatory practices that perpetuate them to this day with the ultimate goal of proposing achievable solutions. Disparities in exposures and harms from pesticides are widespread, impacting BIPOC and low-income communities in both rural and urban settings and occurring throughout the entire lifecycle of the pesticide from production to end-use. These disparities are being perpetuated by current laws and regulations through 1) a pesticide safety double standard, 2) inadequate worker protections, and 3) export of dangerous pesticides to developing countries. Racial, ethnic and income disparities are also maintained through policies and regulatory practices that 4) fail to implement environmental justice Executive Orders, 5) fail to account for unintended pesticide use or provide adequate training and support, 6) fail to effectively monitor and follow-up with vulnerable communities post-approval, and 7) fail to implement essential protections for children. Here we’ve identified federal laws, regulations, policies, and practices that allow for disparities in pesticide exposure and harm to remain entrenched in everyday life for environmental justice communities. This is not simply a pesticides issue, but a broader public health and civil rights issue. The true fix is to shift the USA to a more just system based on the Precautionary Principle to prevent harmful pollution exposure to everyone, regardless of skin tone or income. However, there are actions that can be taken within our existing framework in the short term to make our unjust regulatory system work better for everyone.

Comparative Effectiveness of Training Alternatives for the EPA's Worker Protection Standard Regulation Among Immigrant Latino Farmworkers

OBJECTIVES

To determine the comparative effectiveness of two EPA-approved WPS training strategies.

METHODS

Farmworkers in GA and FL blinded to content before training (N = 339) were randomly assigned to either a video training (n = 121) or a culturally tailored, facilitator-led training (n = 136), or an attention-placebo training focused on heat-related illness (n = 82). Data were obtained immediately before and after training and 3 months after training.

RESULTS

Both active interventions increased pesticide knowledge. At the 3-month follow-up, participants in the EPA video lost acquired knowledge. Those in the facilitator-led group retained acquired knowledge and showed greater pesticide safety behavior.

CONCLUSIONS

Standardized training through video improves short-term knowledge, but it is not retained and unable to support desired behavior to reduce pesticide exposure among farmworkers. A culturally tailored, facilitator-led training is more effective in achieving the spirit of the WPS regulation.

Whose Jurisdiction Is Home Contamination? Para-Occupational 'Take-Home' Herbicide Residue Exposure Risks among Forestry Workers' Families in South Africa

Para-occupational “take-home” exposure risks among forestry workers and their families in low-and middle-income countries (LMICs) have not been well characterized. This is a concern because research shows an association between chronic low-dose herbicide exposure and adverse health effects. This study explored take-home herbicide residue exposure risks among forestry workers in the Western Cape, South Africa, through the community-based participatory research approach of photovoice. A key finding of the study was the absence of provisions related to take-home exposure in the national legislation and workplace policies, which largely contributed to poor adherence to risk reduction practices at worksites, in addition to workers transporting residues to their homes. This study demonstrated evidence of the key omissions regarding take-home exposure at the policy level (e.g., recommendations for employers to reduce take-home risks among employees, and training of workers and their families on take-home exposure) and take-home herbicide residue exposure among worker’s families, including children.

Self-reported work activities, eye, nose, and throat symptoms, and respiratory health outcomes among an industrial hog operation worker cohort, North Carolina, USA

INTRODUCTION

Respiratory disease among industrial hog operation (IHO) workers is well documented; however, it remains unclear whether specific work activities are more harmful and if personal protective equipment (PPE), as used by workers, can reduce adverse health outcomes.

METHODS

IHO workers (n = 103) completed baseline and up to eight bi-weekly study visits. Workers reported typical (baseline) and transient (bi-weekly) work activities, PPE use, and physical health symptoms. Baseline and longitudinal associations were assessed using generalized logistic and fixed-effects logistic regression models, respectively.

RESULTS

At baseline, reports of ever versus never drawing pig blood, applying pesticides, and increasing years worked at any IHO were positively associated with reports of eye, nose, and/or throat irritation. Over time, transient exposures, associated with dustiness in barns, cleaning of barns, and pig contact were associated with increased odds of sneezing, headache, and eye or nose irritation, particularly in the highest categories of exposure. When PPE was used, workers had lower odds of symptoms interfering with sleep (odds ratio [OR]: 0.1; 95% confidence interval [CI]: 0.01-0.8), and eye or nose irritation (OR: 0.1; 95% CI: 0.02-0.9). Similarly, when they washed their hands eight times or more per shift (median frequency) versus less frequently, the odds of any respiratory symptom were reduced (OR: 0.3; 95% CI: 0.1-0.8).

CONCLUSIONS

In this healthy volunteer worker population, increasingly unfavorable IHO activities were associated with self-reported eye, nose, throat, and respiratory health symptoms. Strong protective associations were seen between PPE use and handwashing and the odds of symptoms, warranting further investigation.

Environmental Health Threats to Latino Migrant Farmworkers

Approximately 75% of farmworkers in the United States are Latino migrants, and about 50% of hired farmworkers do not have authorization to work in the United States. Farmworkers face numerous chemical, physical, and biological threats to their health. The adverse effects of these hazards may be amplified among Latino migrant farmworkers, who are concurrently exposed to various psychosocial stressors. Factors such as documentation status, potential lack of authorization to work in the United States, and language and cultural barriers may also prevent Latino migrants from accessing federal aid, legal assistance, and health programs. These environmental, occupational, and social hazards may further exacerbate existing health disparities among US Latinos. This population is also likely to be disproportionately impacted by emerging threats, including climate change and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Latino migrant farmworkers are essential to agriculture in the United States, and actions are needed to protect this vulnerable population.

Congenital heart diseases and parental occupational exposure in a Hungarian case-control study in 1997 to 2002

The etiology of congenital heart diseases is not fully understood yet, however, endocrine disrupting chemicals may have a causative role in their development. The purpose of our study was to examine the association between congenital heart diseases and periconceptional parental occupational exposure to endocrine disrupting chemicals. In our Hungarian population-based case-control study, we examined 2263 live born cases with any congenital heart disease and 6789 matched controls selected between years 1997 to 2002. Occupational exposure was assessed with a job-exposure matrix developed for endocrine disrupting chemicals. Conditional multiple logistic regression analyses were performed to test associations between parental occupational exposure to endocrine disrupting chemicals and congenital heart diseases of the offspring as a whole and by congenital heart disease subtypes. The prevalence of exposure to endocrine disrupting chemicals was 4.5% for both case and control mothers and 19.1% and 19.4% for case and control fathers, respectively. We found a positive association between paternal pesticide (adjusted odds ratio = 1.66, 95% confidence interval: 1.03-2.69) and alkylphenolic compound exposure (adjusted odds ratio = 1.95, 95% confidence interval: 1.30-2.93) and the development of patent ductus arteriosus in the offspring. Alkylphenolic compound exposure occurred among painters, famers, and those working in the food service industry, while pesticide exposure occurred predominantly among farm workers. We identified that certain occupations may increase the occurrence of certain congenital heart disease phenotypes in the offspring. By paying closer attention to those working in these areas, antenatal detection rates of congenital heart diseases may be improved.

Comparison of chemigation versus foliar insecticide use: management of lepidopteran larvae and stink bugs in North Carolina field tomatoes with environmental and farmworker benefits

BACKGROUND

Commercial vegetable production in the United States of America (USA) often relies on foliar insecticide sprays for managing key insect pests. However, foliar applications of insecticides have a number of drawbacks to the health of consumers, farmworkers and the environment. Drip chemigation is the application of pesticides to the soil through trickle (drip) irrigation systems, and can overcome a number of the drawbacks typical of foliar insecticide applications.

RESULTS

We conducted a two-year study in five commercial fields of staked tomatoes in western North Carolina to compare the efficacy, economics and environmental impact of drip chemigation versus foliar sprays. Drip chemigation significantly reduced insecticide inputs, utilized more selective and environmentally compatible insecticides, and reduced the time lost to reentry intervals, while maintaining comparable efficacy and economic returns.

CONCLUSIONS

Drip chemigation was an effective tool for managing key insect pests, provided a broad range of human and environmental health benefits, and will likely become increasingly cost-effective in the future as insecticide patents expire and more insecticide options become available.

Organophosphate toxicity: updates of malathion potential toxic effects in mammals and potential treatments

Organophosphorus insecticides toxicity is still considered a major global health problem. Malathion is one of the most commonly used organophosphates nowadays, as being considered to possess relatively low toxicity compared with other organophosphates. However, widespread use may lead to excessive exposure from multiple sources. Mechanisms of MAL toxicity include inhibition of acetylcholinesterase enzyme, change of oxidants/antioxidants balance, DNA damage, and facilitation of apoptotic cell damage. Exposure to malathion has been associated with different toxicities that nearly affect every single organ in our bodies, with CNS toxicity being the most well documented. Malathion toxic effects on liver, kidney, testis, ovaries, lung, pancreas, and blood were also reported. Moreover, malathion was considered as a genotoxic and carcinogenic chemical compound. Evidence exists for adverse effects associated with prenatal and postnatal exposure in both animals and humans. This review summarizes the toxic data available about malathion in mammals and discusses new potential therapeutic modalities, with the aim to highlight the importance of increasing awareness about its potential risk and reevaluation of the allowed daily exposure level.

Health and safety of pesticide applicators in a high income agricultural setting: a knowledge, attitude, practice, and toxicity study from North-Eastern Italy

Background

We assessed knowledge, attitudes and practices regarding pesticide handling and related health problems among pesticide applicators (PAs) from the Autonomous Province of Trento, Italy.

Methods

A cross-sectional questionnaire-based study was performed in spring 2016, involving 260 PAs. Logistic regression analyses were used to identify factors associated with a safer use of pesticides.

Results

The mean age of participants was 48.8 ± 13.2 years. 89.2% were males. Use of personal protective equipment (PPE) was diffuse, particularly gloves (92.7%), face mask (91.2%), and post-spraying personal hygiene practices were extensively applied. Overall, 43.5% had experienced pesticide-related symptoms especially in subjects misusing PPE, but also for avoiding hygienic procedures. Knowledge about pesticides was a significant predictor for frequency of symptoms.

Conclusions

As a better knowledge of pesticide-related risks was a significant predictor to reduce symptoms, our results stress that improving awareness and promoting safe use of pesticide may improve the health of PAs.

Engaging outreach workers in the development of a farmworker health research agenda

Farmworker health outreach workers have not traditionally been involved in the prioritization and design of research studies. This report from the field shares the results of a survey administered to outreach workers providing health services to farmworkers in North Carolina. Priority areas of research and best practices for engaged research are presented from the perspective of the outreach worker community. The purposeful involvement of outreach workers can make farmworker health research more meaningful and solution-oriented.

Factors affecting pesticide safety behaviour: The perceptions of Nepalese farmers and retailers

Indiscriminate use of pesticides in vegetable farming is an emerging problem resulting in increasing health and environmental risks in developing countries including Nepal. As there are limited studies focusing on farmers' and retailers' knowledge related to pesticide use and associated risks as well as safety behaviour, this study assesses their perceptions of pesticide use, associated impacts on human and environmental health and safety behaviours. This study is also intended to quantify pesticide use in vegetable farming. We used the Health Belief Model (HBM) to evaluate farmers' and retailers' safety behaviour associated with pesticides. We interviewed 183 farmers and 45 retailers. The study revealed that farmers applied pesticides at an average of 2.9kga.i./ha per crop per season; and insecticides, especially pyrethrins and pyrethroids as well as organophosphate, were the most frequently used. Retailers were more aware of the threats surrounding pesticide use and were thus more aware of the risks to their own health as well as to the health of animals, birds, fishes, and honey bees. Headache (73.8%) was the most commonly reported acute health symptom of pesticide use. Farmers often did not adopt the appropriate safety measures when handling pesticides sighting the constrained perceived barriers (direct path coefficient, DPC=-0.837) such as feeling uncomfortable and the unavailability of safety measures. Likewise, retailers lacked the incentive (direct path coefficient, DPC=0.397) to adopt the necessary safety measures while handling pesticides. Training and awareness programs addressing safe handling practices and safety measures as well as education concerning the long-term risks of pesticide exposure on health and the environment, through radio, television and posters, may improve the safety behaviour of farmers and retailers.

Perceived usefulness of personal protective equipment in pesticide use predicts farmers' willingness to use it

Personal protective equipment (PPE) can substantially reduce the risk exposure from pesticide spraying, but compliance is rather low, particularly among small-scale farmers. In this study the connection between farmers' willingness to use PPE in pesticide handling and perceptions of PPE usefulness was examined through a survey of 341 small-scale farmers in Gorgan county of Golestan Province, Iran. Farmers who were not using PPE when working with pesticides were purposively selected to better serve the objective of the study. Multinomial logit regression models were employed to examine differences in farmers' willingness to use PPE in the future. Almost four out of ten farmers (38.1%) showed willingness to use PPE. However, 36.7% of the farmers showed unwillingness and 25.2% were unsure about using PPE. The average score of farmers' perceptions of PPE disadvantages (x=0.55) was significantly higher than the corresponding score of PPE advantages (x=0.38). Low availability and high price were considered the most important constraints in PPE use by the majority of farmers (75.4% and 74.8% of the farmers, respectively). Farmers who perceived usefulness of PPE, such as effectiveness, safety, and ease of use, were more willing to use PPE in the future. Those who perceived non-usefulness of PPE, driven by unavailability, high price, lack of use by neighbors or colleagues, and ignorance of PPE in extension trainings, were less likely to use PPE in the future. Findings revealed that willingness to use PPE among small-scale farmers when working with pesticides is strongly linked to their perception of PPE usefulness. Findings raise our understanding of the important role of farmers' knowledge in PPE acceptance and use and can motivate policy-makers to pay more attention to the role of farmers' perceptions and awareness in the success or failure of health and safety programs. It is necessary to incorporate farmers' preferences in extension programs to promote safety measures during working with pesticides.

Assessment of field re-entry exposure to pesticides: A dislodgeable foliar residue study

A dislodgeable foliar residue study was conducted in greenhouse pepper and tomato on the island of Crete, Greece, following the spray application of an SC insecticide (with active substance (a.s.) tebufenozide) and an EC fungicide (a.s. bupirimate). Furthermore, for the assessment of worker exposure to pesticides - as a result of re-entering the treated crops - a worker dermal exposure study was carried out during the tasks of tying or pruning, which allowed the transfer coefficient values for the specific tasks to be determined. Pesticide residues were analysed with an in house developed and fully validated HPLC-ESI/MS analytical method. The results from the study resulted in transfer coefficient values which were in agreement with current EFSA guideline values in most of the cases with the exception of bupirimate in a tomato greenhouse. In that case, high potential dermal exposure and low dislodgeable foliar residue values were observed, which is thought to be due to the moist leaves collected during sampling and monitoring, which led to greater than expected transfer coefficient values.

Longitudinal assessment of occupational determinants of chlorpyrifos exposure in adolescent pesticide workers in Egypt

Chlorpyrifos (CPF) is an organophosphourus insecticide applied to cotton fields by adolescents employed by the Egyptian Ministry of Agriculture. Urinary 3,5,6-trichloro-2-pyridinol (TCPy) is a biomarker of CPF exposure that has substantial variability among these applicators. In order to identify predictors of CPF exposure, we conducted a longitudinal study of 43 adolescent pesticide applicators in Egypt from April 2010 to January 2011 in Egypt. Urinary TCPy was quantified at 25 time-points, prior to, during, and following application. We used log-linear regression and a best subset selection approach to identify the exposure determinants that were most predictive of cumulative TCPy and participants' highest TCPy values (peak exposure). Applicators had cumulative urinary TCPy levels ranging from 167 to 49,8208μg/g creatinine. Total hours applying CPF (semi-partial r²=0.32), and total hours in the field applying other pesticides (semi-partial r²=0.08) were the strongest predictors of cumulative TCPy. Applicators had peak urinary TCPy levels ranging from 4 to 5715μg/g creatinine. The amount of time applying pesticides prior to blood draw was the strongest predictor of peak TCPy (semi-partial r²=0.30). We also observed evidence that wearing clean clothes to work was associated with lower longitudinal TCPy. Our results suggest there is an opportunity for targeted interventions, particularly related to hygiene or implementation of personal protective equipment usage to reduce CPF exposure among adolescent pesticide workers.

Harvesters in strawberry fields: A literature review of pesticide exposure, an observation of their work activities, and a model for exposure prediction

Strawberry harvesters hand-pick fruit that may result in pesticide exposure from hand foliar contact. This paper included a review of publications on harvester pesticide exposure, an observation of their work activities, and development of an alternative model for pesticide exposure prediction. Previous studies monitored the dermal pesticide exposure of strawberry harvesters and found most of the exposure (>70%) was on the hands. Exposure rates (ERs) were calculated as pesticide amount on the skin per hour worked, assuming foliar contact is proportional to daily work hours. Transfer factors (TFs), used for predicting exposure, were calculated by dividing the ER by the amount of dislodgeable foliar pesticide residue. However, the ERs for harvesters working in the same field at the same time varied by as much as 10-fold, and TFs calculated from different studies varied by up to 100-fold. We tested the assumption of foliar contact time being proportional to daily work hours. We observed full work-day activities of 32 strawberry harvesters. We found that their foliar contact time per work minute differed by up to 46%. We suggested using the amount of strawberries picked to predict harvester foliar contact. For all observed harvesters, their foliar contact time per kg of strawberries picked was 35±5 s. This value was similar among harvesters with varying years of experience, of different gender, and using gloves or not. We proposed a predictive model using the amount of strawberries picked to predict harvester pesticide exposure. The exposure predicted by the model is close to the exposure measured in previous monitoring studies (R²: 0.84). The model slope is 0.33±0.03 × 10³ cm²/kg. Model prediction accuracy was confirmed by monitoring captan exposure to harvesters in two fields. The model may be used as a quick screening method to estimate pesticide exposure before conducting complex human monitoring research.

Benefits, Facilitators, Barriers, and Strategies to Improve Pesticide Protective Behaviors: Insights from Farmworkers in North Carolina Tobacco Fields

Pesticide exposure is associated with deleterious health effects. Prior studies suggest Latino farmworkers perceive little control over their occupational health. Using the Health Belief Model as a theoretical guide, we explored the perceptions of Latino farmworkers working in tobacco in North Carolina (n = 72) about benefits and facilitators of pesticide protective behaviors as well as barriers, and strategies to overcome barriers to their use. Interviews were conducted with participants at farmworker housing during non-work time. Qualitative data were analyzed using ATLAS.ti. Farmworkers recognized pesticide protective behaviors as helping them to not get sick and stay healthy. Farmworkers perceived work experience as facilitating protective behaviors. Wetness in the field was the most commonly cited barrier to protective behavior use. To overcome this barrier, farmworkers suggested use of water-resistant outerwear, as well as packing a change of clothes for mid-day, with space and time to change provided by employers. Examination of the efficacy and feasibility of farmworkers' suggestions for addressing barriers is warranted. Training and behavior modeling by experienced peers may improve behavior adoption and perceived control.

Association of health symptoms with low-level exposure to organophosphates, DNA damage, AChE activity, and occupational knowledge and practice among rice, corn, and double-crop farmers

Objectives:

This study aims to determine (1) total dialkylphosphate (ΣDAP) levels, occupational knowledge and practice, DNA damage, AChE activity, and health symptoms in rice, corn, and double-crop farmers; (2) the association of health symptoms with ΣDAP levels, occupational knowledge and practice, DNA damage, and AChE activity in farmers; and (3) the prevalence of health symptoms between farmers and non-farmers.

Methods:

A cross-sectional study was conducted by interviewing as well as analyzing urine and blood samples during July to August 2014.

Results:

There were no differences in ΣDAP levels, AChE activity, and occupational knowledge and practice scores among all farmer groups. In terms of health symptoms related to ΣDAP, AChE activity, DNA damage, and occupational knowledge and practice, pesticide-related symptoms were determined, including breathlessness, chest pain, dry throat, numbness, muscle weakness, cramp, headache, dizziness, eye irritation, white/red rash, and white/red pimple, which were classified as respiratory, muscle, nervous, and epithelial symptoms. A remarkable finding was that farmers had a significantly higher prevalence of muscle weakness (odds ratio (OR)=3.79) and numbness (OR=3.45) as compared with non-farmers.

Conclusion:

Our findings, therefore, suggest that a long-term low-level exposure to organophosphates (OPs) may be associated with an increasing prevalence of muscle symptoms. However, a further cohort study incorporating sensitive health outcomes and measurement of multiple pesticides monitoring on a larger scale is warranted.

Pesticides: Perceived Threat and Protective Behaviors Among Latino Farmworkers

OBJECTIVES

The purpose of this study was to assess the knowledge and beliefs of 72 Latino farmworkers in North Carolina about the threat of health effects of pesticides, including cancer. It sought to explore relationships between threat perceptions and pesticide protective behaviors observed in the field.

METHODS/RESULTS

Utilizing stepwise multiple regression, the authors found that years worked in agriculture in the United States was associated with decreased use of protective clothing.

CONCLUSION

Pesticide protective behaviors in the field may be improved by utilizing moderately experienced farmworkers (<10 years) as lay advisors to reinforce training.

Exposure to pesticides and the associated human health effects

Pesticides are used widely to control weeds and insect infestation in agricultural fields and various pests and disease carriers (e.g., mosquitoes, ticks, rats, and mice) in houses, offices, malls, and streets. As the modes of action for pesticides are not species-specific, concerns have been raised about environmental risks associated with their exposure through various routes (e.g., residues in food and drinking water). Although such hazards range from short-term (e.g., skin and eye irritation, headaches, dizziness, and nausea) to chronic impacts (e.g., cancer, asthma, and diabetes), their risks are difficult to elucidate due to the involvement of various factors (e.g., period and level of exposure, type of pesticide (regarding toxicity and persistence), and the environmental characteristics of the affected areas). There are no groups in the human population that are completely unexposed to pesticides while most diseases are multi-causal to add considerable complexity to public health assessments. Hence, development of eco-friendly pesticide alternatives (e.g., EcoSMART) and Integrated Pest Management (IPM) techniques is desirable to reduce the impacts of pesticides. This paper was hence organized to present a comprehensive review on pesticides with respect to their types, environmental distribution, routes of exposure, and health impacts.

Hydration and Cooling Practices Among Farmworkers in Oregon and Washington

OBJECTIVES

Although recommendations for preventing occupational heat-related illness among farmworkers include hydration and cooling practices, the extent to which these recommendations are universally practiced is unknown. The objective of this analysis was to compare hydration and cooling practices between farmworkers in Oregon and Washington.

METHODS

A survey was administered to a purposive sample of Oregon and Washington farmworkers. Data collected included demographics, work history and current work practices, hydration practices, access and use of cooling measures, and headwear and clothing worn.

RESULTS

Oregon farmworkers were more likely than those in Washington to consume beverages containing sugar and/or caffeine. Workers in Oregon more frequently reported using various cooling measures compared with workers in Washington. Availability of cooling measures also varied between the two states.

CONCLUSIONS

These results highlight the large variability between workers in two states regarding access to and use of methods to stay cool while working in the heat.

Methodological concerns related to response bias in migrant and seasonal farmworkers

BACKGROUND

The original objective was to measure the impact of kneepads on musculoskeletal pain in migrant and seasonal farmworkers (MSFWs). Secondary analyses were conducted to quantify the extent to which response bias may have skewed the study's results.

METHODS

Surveys were used to collect data on baseline pain and post-intervention pain, the amount of time participants spent wearing kneepads, and their overall ratings of the intervention.

RESULTS

Participants did not experience significantly less pain with kneepads, and wore them for considerably less than the prescribed amount of time. However, subjects rated them very favorably. Given the strong suspicion of response bias, no firm conclusions could be drawn regarding the intervention.

CONCLUSIONS

Unique survey methodologies must be used with MSFWs, who tend to have low research literacy and are particularly susceptible to response bias. Objective study outcomes are particularly favorable in this population in order to minimize dependence on self-reported measures. Am. J. Ind. Med. 59:1112-1119, 2016. © 2016 Wiley Periodicals, Inc.

Assessment of personal protective equipment use among farmers in eastern North Carolina: a cross-sectional study

Agriculture consistently ranks among the top hazardous occupations, accounting for a significant number of injuries and fatalities in the workplace. Eastern North Carolina has a significant number of small, independent, family-run, owned, and operated farms. However, little is known about perception, behavior, training, accessibility, or purchasing personal protective equipment (PPE) for safety among farmers in the region. In this study, telephone interviews were conducted among participating farmers between March and June 2012 (N = 129). Univariate and bivariate analyses were conducted to examine associations between PPE behavior and workplace hazards, health-related concerns, and wearing and purchasing PPE. Findings indicated that personal behavior of wearing hearing protection devices (HPDs) and protection from the sun among farmers was low. However, a relatively high percentage of farmers reported wearing PPE when working with agricultural chemicals. Most farmers received training from agricultural extension offices. The findings indicate that, in general, farmers are well aware of the risks associated with occupational hazards and recognize concern for health and safety protection in the workplace. Transitioning these concerns into preventative action remains a challenge and priority for the agricultural health professional.

Provision Increases Reported PPE Use for Mexican Immigrant Farmworkers: An mHealth Pilot Study

OBJECTIVE

Personal protective equipment (PPE) reduces pesticide exposures, but many farmworkers complain that it is difficult to obtain. We examined if PPE provision increased usage. We also delivered motivational messaging aimed to promote PPE use.

METHODS

First, we delivered a daily survey through a mobile phone app to assess PPE use. Farmworkers subsequently received a daily, individualized motivational message based on their PPE use and reported difficulties. PPE use was evaluated at baseline and at the close of the study.

RESULTS

PPE behaviors improved for gloves (P ≤ 0.01) and safety glasses (P ≤ 0.001). Use of long-sleeved shirts, hats, and long pants were already consistently used at baseline and did not exhibit significant change.

CONCLUSIONS

Our findings demonstrate that PPE provision and delivery of motivational messaging through mobile phones may increase PPE usage for farmworkers.

Observed and self-reported pesticide protective behaviors of Latino migrant and seasonal farmworkers

Agricultural pesticide exposure has potential adverse health effects for farmworkers that may be reduced by pesticide protective behaviors (PPBs). The Environmental Protection Agency's (EPA) Worker Protection Standard (WPS) requires PPBs be taught to farmworkers prior to field work. Studies to date have not utilized observational methods to evaluate the degree to which PPBs are practiced by Latino migrant and seasonal farmworkers in the United States. The purpose of this study was to describe, compare, and contrast observed and self-reported PPBs used by Latino farmworkers; both PPBs that the WPS requires be taught and other PPBs were included. Observed and self-reported data were collected from 71 Latino farmworkers during the 2014 tobacco growing season in North Carolina. Participants were consistent in reporting and using long pants and closed shoes in the field most of the time. In addition, gloves, hats/bandanas, and water-resistant outerwear were frequently observed, although they are not required to be taught by the WPS. Farmworkers reported more long-sleeve (p=.028) and glove use (p=.000) than what was observed. It was uncommon to observe washing behavior before eating or drinking, even when washing supplies were available. Washing behaviors were significantly overreported for hand (p=.000; p=.000) and face (p=.000; p=.058) washing before eating and drinking in the field. This study documents that protective clothing behaviors that the WPS requires be taught, plus a few others are commonly practiced by Latino migrant and seasonal farmworkers, but washing behaviors in the field are not. Targeted strategies to improve washing behaviors in the field are needed.

User Perceptions of ¡Protéjase!: An Intervention Designed to Increase Protective Equipment Use Among Mexican Immigrant and Mexican American Farmworkers

BACKGROUND

Farmworkers' exposures to pesticides are reduced when they wear personal protective equipment (PPE), and mobile health (mHealth) platforms can potentially deliver information to farmworkers to help promote PPE use. However, little is known about the feasibility of using mHealth platforms to promote farmworkers' use of PPE.

OBJECTIVE

The objective of the study was to describe the development and feasibility-testing of Protect Yourself! (¡Protéjase!), an intervention designed to increase PPE use. As the vast majority of farmworkers in the United States are from Mexico, we examined the intervention in a primarily Mexican-origin farmworker population.

METHODS

¡Protéjase was developed in several steps. First, we performed ethnographic observations to understand what prevents PPE use. Next, we developed program components that met the challenges uncovered in the ethnographic observations, seeking direct feedback from farmworkers on each component. Feasibility was assessed using surveys and focus groups. Material was provided in Spanish or English at the preference of the participant. Finally, we pilot tested each component of the intervention, including: (1) PPE that was provided to each worker for their personal use during the intervention trial, and (2) delivery of an application-based tool that promoted the use of PPE through daily individualized messaging.

RESULTS

55 farmworkers enrolled in the study, but only 41 of 55 (75%) completed the entire pilot intervention trial. Results focus on the evaluation of the intervention, and include only those who completed the entire trial. Among farmworkers who completed the entire intervention trial, all but two farmworkers were born in Mexico and were Spanish speaking. Still, all study participants self-identified as Mexican or Mexican-American. When asked what changes were needed in the intervention's messaging or delivery to increase user satisfaction, 22 out of 41 participants (54%) felt that no changes were needed. However, 16 of 41 participants (39%) suggested small changes to messaging (eg, refer to long pants as pants only) to improve their understanding of the messages. Finally, a small number (3 of 41 participants, 7%) felt that messages were difficult to read, primarily due to low literacy.

CONCLUSIONS

The ¡Protéjase! mHealth program demonstrated very good feasibility, satisfaction, and acceptance; potential improvements (eg, small modifications in messaging to increase farmworkers' use) were noted. Overall, the PPE provided to workers as well as the mHealth platform were both perceived as useful for promoting PPE use.

Protective glove use and hygiene habits modify the associations of specific pesticides with Parkinson's disease

Pesticides have been associated with Parkinson's disease (PD), and protective gloves and workplace hygiene can reduce pesticide exposure. We assessed whether use of gloves and workplace hygiene modified associations between pesticides and PD. The Farming and Movement Evaluation (FAME) study is a nested case-control study within the Agricultural Health Study. Use of protective gloves, other PPE, and hygiene practices were determined by questionnaire (69 cases and 237 controls were included). We considered interactions of gloves and hygiene with ever-use of pesticides for all pesticides with ≥5 exposed and unexposed cases and controls in each glove-use stratum (paraquat, permethrin, rotenone, and trifluralin). 61% of respondents consistently used protective gloves and 87% consistently used ≥2 hygiene practices. Protective glove use modified the associations of paraquat and permethrin with PD: neither pesticide was associated with PD among protective glove users, while both pesticides were associated with PD among non-users (paraquat OR 3.9 [95% CI 1.3, 11.7], interaction p=0.15; permethrin OR 4.3 [95% CI 1.2, 15.6] interaction p=0.05). Rotenone was associated with PD regardless of glove use. Trifluralin was associated with PD among participants who used <2 hygiene practices (OR 5.5 [95% CI 1.1, 27.1]) but was not associated with PD among participants who used 2 or more practices (interaction p=0.02). Although sample size was limited in the FAME study, protective glove use and hygiene practices appeared to be important modifiers of the association between pesticides and PD and may reduce risk of PD associated with certain pesticides.

Potential health effects associated with dermal exposure to occupational chemicals

There are a large number of workers in the United States, spanning a variety of occupational industries and sectors, who are potentially exposed to chemicals that can be absorbed through the skin. Occupational skin exposures can result in numerous diseases that can adversely affect an individual's health and capacity to perform at work. In general, there are three types of chemical-skin interactions of concern: direct skin effects, immune-mediated skin effects, and systemic effects. While hundreds of chemicals (metals, epoxy and acrylic resins, rubber additives, and chemical intermediates) present in virtually every industry have been identified to cause direct and immune-mediated effects such as contact dermatitis or urticaria, less is known about the number and types of chemicals contributing to systemic effects. In an attempt to raise awareness, skin notation assignments communicate the potential for dermal absorption; however, there is a need for standardization among agencies to communicate an accurate description of occupational hazards. Studies have suggested that exposure to complex mixtures, excessive hand washing, use of hand sanitizers, high frequency of wet work, and environmental or other factors may enhance penetration and stimulate other biological responses altering the outcomes of dermal chemical exposure. Understanding the hazards of dermal exposure is essential for the proper implementation of protective measures to ensure worker safety and health.

Breaking the take home pesticide exposure pathway for agricultural families: workplace predictors of residential contamination

BACKGROUND

Pesticides used in agriculture can be taken into worker homes and pose a potential risk for children and other family members. This study focused on identification of potential intervention points at the workplace.

METHODS

Workers (N = 46) recruited from two tree fruit orchards in Washington State were administered a 63-item pesticide safety questionnaire. Dust was collected from commuter vehicles and worker homes and analyzed for four organophosphorus (OP) pesticides (azinphosmethyl, phosmet, chlorpyrifos, malathion).

RESULTS

Geometric mean azinphosmethyl concentrations in dust for three worker groups (16 pesticide handlers, 15 green fruit thinners, 15 organic orchard workers) ranged from 0.027-1.5 μg/g, with levels in vehicle dust higher than in house dust, and levels in house dust from handlers' homes higher than levels from tree fruit thinners' homes. Vehicle and house dust concentrations of azinphosmethyl were highly associated (R(2) = 0.44, P < 0.001). Significant differences were found across worker groups for availability of laundry facilities, work boot storage, frequency of hand washing, commuter vehicle use, parking location, and safety training.

CONCLUSIONS

These findings support a focus on intervention activities to reduce take home pesticide exposure closer to the source of contamination; specifically, the workplace and vehicles used to travel to the workplace.

Effectiveness of pesticide safety training and knowledge about pesticide exposure among Hispanic farmworkers

BACKGROUND

Pesticide poisoning rates remain high among farmworkers despite programs aimed at reducing pesticide exposure.

METHODS

A cross-sectional study was conducted among 187 Hispanic farmworkers in North Carolina. Farmworkers were interviewed to determine the association between pesticide safety training and knowledge about pesticides and use of personal protective equipment (PPE).

RESULTS

Use of PPE was higher among farmworkers who reported wearing gloves reduced the harmful effects of pesticides (adjusted odds ratio, 5.73; 95% confidence interval, 2.20-14.92) and those who received pesticide safety training at the extension office or growers association (adjusted odds ratio, 44.62; 95% confidence interval, 3.96-503.33).

CONCLUSION

Some farmworkers are still not using PPE. Evaluation of Environmental Protection Agency Worker Protection Standards pesticide safety training and requirements for providing PPE are crucial to encourage farm workers to use PPE.

Health Risk Behaviors Associated With Agrochemical Exposure Among Rice Farmers in a Rural Community, Thailand

The study objective was to evaluate health beliefs and behaviors associated with agrochemical exposure among rice farmers. We applied the Health Belief Model, community-based ethnography, and public health risk assessment for this study. Data were collected from 101 rice farmers in Khlong Seven community between January and June 2010. Data comprised observations, unstructured and semistructured interviews, and focus group discussions. We showed that farmers had moderate levels of perceived susceptibility to, severity of, benefits of, and barriers to using agrochemicals safely. The major risk factors related to agrochemical exposure resulted from the misuse of pesticides, including erroneous beliefs of farmers regarding pesticide toxicity, the use of faulty spraying equipment, the lack of proper maintenance of spraying equipment, or the lack of protective gear and appropriate clothing. An intervention program is necessary to improve safety with regard to agrochemicals in the rice Khlong Seven community.

Pilot study of pesticide knowledge, attitudes, and practices among pregnant women in northern Thailand

An estimated 200,000 children born in Thailand each year are at risk of prenatal exposure to pesticides and associated neurodevelopmental outcomes because of their mothers’ agricultural occupations. Children born to non-agricultural workers may also be at risk of exposure from other pathways of maternal pesticide exposure, including exposure through home use, diet, and other environmental media. Pesticide exposure in Thailand has been linked to unsafe practices and beliefs about pesticides. However, limited information exists on pesticide knowledge, attitudes, and practices among pregnant women in Thailand or elsewhere. Obtaining this information is essential to understand the factors associated with prenatal pesticide exposure, identify populations potentially at risk, and ultimately protect pregnant women and their children. We administered surveys to 76 pregnant women in northern Thailand and used multivariable logistic regression to evaluate associations among pesticide-related knowledge, pregnancy trimester, and pesticide use behavior. In this pilot study, lower knowledge score and earliest trimester of pregnancy were marginally (p < 0.1) associated with unsafe practices in the home, but not at work. Women who worked in agriculture or applied pesticides before becoming pregnant, or who had a previous child were significantly (p < 0.05) more likely to engage in unsafe behaviors in the home during their current pregnancy. We preliminarily conclude that increasing pesticide-related knowledge among pregnant women may help promote safe practices and reduce prenatal exposure. Knowledge-based interventions may be most effective when implemented early in pregnancy and targeted to agricultural workers and other sub-populations at risk of pesticide exposure.

Do workplace and home protective practices protect farm workers? Findings from the "For Healthy Kids" study

OBJECTIVE

To assess associations of protective workplace and home practices with pesticide exposure levels.

METHODS

Using data from orchard workers in the Yakima Valley, Washington, we examined associations of workplace and home protective practices with (1) urinary metabolite concentrations of dimethylthiophosphate (DMTP) in adults and children aged 2 to 6 years and (2) azinphos-methyl levels in house and vehicle dust.

RESULTS

Data were collected from 95 orchard workers and 94 children. Contrary to expectation, adult farm workers who wore boots or washed hands using hand sanitizer had higher concentrations of DMTP than those who did not. Children who attended daycare had higher DMTP concentrations than children who did not.

CONCLUSIONS

Few workplace or home practices were associated with pesticide exposure levels; workers who used hand sanitizer had higher concentrations of DMTP, as did children who attended daycare.

Multi-approach model for improving agrochemical safety among rice farmers in Pathumthani, Thailand

The large-scale use of agrochemicals has raised environmental and human health concerns. A comprehensive intervention strategy for improving agrochemical safety among rice farmers in Thailand is lacking. The objective of this study is to develop a model in order to improve farmers' health and prevent them from being exposed to agrochemical hazards, in addition to evaluating the effectiveness of the intervention in terms of agrochemical safety. This study was conducted between October 2009 and January 2011. It measures changes in the mean scores of agrochemical knowledge, health beliefs, agrochemical use behaviors, and in-home pesticide safety. Knowledge of agrochemical use constitutes a basic knowledge of agrochemicals and agrochemical safety behaviors. Health beliefs constitute perceived susceptibility, severity, benefits, and barriers to using agrochemicals. Agrochemical use behaviors include self-care practices in terms of personal health at specific times including before spraying, while spraying, during storage, transportation, waste management, and health risk management. Fifty rice farmers from Khlong Seven Community (study group) and 51 rice farmers from Bueng Ka Sam community (control group) were randomly recruited with support from community leaders. The participants were involved in a combination of home visits (ie, pesticide safety assessments at home) and community participatory activities regarding agrochemical safety. This study reveals that health risk behaviors regarding agrochemical exposure in the study area are mainly caused by lack of attention to safety precautions and the use of faulty protective gear. After 6 months, the intervention program showed significant improvements in the overall scores on knowledge, beliefs, behaviors, and home pesticide safety in the study group (P < 0.05). Therefore, this intervention model is effective in improving agrochemical safety behaviors among Khlong Seven Community rice farmers. These findings demonstrate that a multi-approach model for improving agrochemical safety behaviors can lead to sustainable prevention of agrochemical hazards for farmers.

Effect of abamectin exposure on semen parameters indicative of reduced sperm maturity: a study on farmworkers in Antalya (Turkey)

Environmental exposure to pesticides may cause serious health risks including fertility and reproductive function. The aim of this study was to highlight whether there is a relationship between exposure to abamectin and male fertility parameters of farmworkers. Twenty male farmworkers who were using abamectin and 20 men not exposed to pesticides were recruited as experimental and control groups, respectively. Semen analysis, molecular markers of sperm maturity and serum reproductive hormone levels were evaluated. In experimental group, high plasma abamectin levels were detected. These men have decreased sperm motility. Moreover, diminished molecular markers of sperm maturity, such as decreased hyaluronic acid (HA) binding of sperm, increased numbers of aniline blue positive sperm and increased percentage of creatine kinase (CK) positive sperm, were observed in abamectin-exposed men. Their serum testosterone, LH and FSH levels did not change significantly. We conclude that exposure to abamectin may impair male fertility by effecting semen quality.

Risk-accepting personality and personal protective equipment use within the Agricultural Health Study

Pesticide exposures can be reduced by use of personal protective equipment as well as proper mixing and application practices. The authors examined the effects of risk-accepting personality on personal protective equipment (PPE) use and mixing and application practices among private pesticide applicators and their spouses within the Agricultural Health Study (AHS) in Iowa and North Carolina and commercial applicators in Iowa. The AHS follow-up questionnaire included four questions designed to assess attitudes toward risk. Analysis was limited to those who were currently working on a farm or registered as a commercial applicator and indicated current pesticide use (n=25,166). Respondents who answered three or more questions in the affirmative (private applicators: n=4160 [21%]; commercial applicators: n=199 [14%]; spouses: n=829 [23%]) were classified as having a risk-accepting personality. Logistic regression was used to evaluate specific work practices associated with risk-accepting attitudes. Among private applicators, the likelihood of using any PPE when mixing or loading pesticides was lower among risk-acceptors compared to risk-averse individuals (odds ratio [OR] = 0.72, 95% confidence interval [CI]: 0.65-0.79). A similar relationship was observed among commercial applicators (OR = 0.77, 95% CI: 0.34-1.77) but not among spouses (OR = 1.09, 95% CI: 0.90-1.33). Among private applicators, risk-acceptors were more likely than the risk-averse to apply pesticides within 50 feet of the home (OR = 1.21, 95% CI: 1.01-1.44), compared to further than ¼ mile. These findings suggest that the decisions to use personal protective equipment and properly handle/apply pesticides may be driven by risk-accepting personality traits.

Practices in pesticide handling and the use of personal protective equipment in Mexican agricultural workers

Practices related to the safe handling of pesticides and use of personal protective equipment (PPE) are largely unknown among agricultural workers in developing countries. The authors obtained information from 99 Mexican agricultural workers (35 women and 64 men) who answered questions on sociodemographic data, agricultural practices, use of pesticides, use of PPE, and risk perception. As expected, men handled pesticides more frequently than women (67% versus 20%). The workers carried out several agricultural tasks, as is customary in the case of fieldworkers who (1) work in small agricultural enterprises; use a great number of pesticide products (59 commercial brands of pesticides, 33 active ingredients, and 20 chemical families); (2) use mostly manual application equipment; (3) have a low rate of correct usage of PPE (2%), which does not vary according to the education level, the time of year, or the risk perception; and (4) have insufficient hygienic practices. In addition, storage of pesticide products and application equipment at home is frequent among this group of workers (42%), and provides a significant source of para-occupational exposure for the workers' families. These results show the need to develop prevention programs to reduce risks posed by pesticides to agricultural workers and their families.

The role of employers and supervisors in promoting pesticide safety behavior among Florida farmworkers

BACKGROUND

Farmworkers in Florida's nursery and fernery industries have an elevated risk of exposure to chemical pesticides due to the enclosed nature of their workplaces and their close contact with pesticide-treated plant material. Farmworkers' beliefs about chemical exposures and their perception of employer's or supervisor's valuing of safety may limit the practice of workplace hygiene.

METHODS

Three hundred eighty-two surveys from workers in the nursery and fernery industries in North Central Florida were collected as part of the Together for Agricultural Safety (TAS) Project from 1999-2001. Univariate analyses and multivariate Ordinary Least Squares regression are used to examine the role of individual and structural characteristics on handwashing practices.

RESULTS

Workplace practices such as the provision of written notices of recent pesticide application and the provision of convenient handwashing facilities are important predictors of workplace hygiene. Although farmworker attitudes and beliefs towards the utility of such practices and potential hazards are associated with behavior, they are less significant than the structural variables.

CONCLUSIONS

In order for farmworkers to engage in safety behavior that will protect their health, they must be adequately instructed and supported by employers and/or supervisors.

Repeated pesticide exposure among North Carolina migrant and seasonal farmworkers

BACKGROUND

Limited data document the multiple and repeated pesticide absorption experienced by farmworkers in an agricultural season or their risk factors.

METHODS

Data were collected from 196 farmworkers four times at monthly intervals in 2007. Urine samples were tested for 12 pesticide urinary metabolites. Questionnaire data provided measures of exposure risks.

RESULTS

Farmworkers had at least one detection for many pesticide urinary metabolites; for example, 84.2% had at least one detection for acephate, 88.8% for 3,5,6-trichloro-2-pyridinol. Most farmworkers had multiple detections for specific metabolites; for example, 64.8% had two or more detections for acephate, 64.8% for 3,5,6-trichloro-2-pyridinol, 79.1% for 3-phenoxybenzoic acid, and 86.7% for 2,4-dichlorophenoxyacetic acid. Housing type had a consistent significant association with metabolite detections.

CONCLUSIONS

Farmworkers are exposed to multiple pesticides across an agricultural season, and they experience repeated exposures to the same pesticides. Reducing farmworker pesticide exposure and delineating the health outcomes of this exposure require more detailed data. Am. J. Ind. Med. 53:802-813, 2010. (c) 2010 Wiley-Liss, Inc.

Cholinesterase depression and its association with pesticide exposure across the agricultural season among Latino farmworkers in North Carolina

BACKGROUND

Farmworkers can be exposed to a wide variety of pesticides. Assessing cholinesterase activity over time can be used to monitor exposure to organophosphorus and carbamate pesticides.

OBJECTIVES

The goal of this study was to document patterns and variation in cholinesterase levels across the agricultural season (May-August) among field-workers, and to explore the association of cholinesterase depression with pesticide exposure across the agricultural season.

METHODS

Dried blood samples collected from 231 migrant farmworkers sampled from camps in eastern North Carolina up to four times across a summer agricultural season were analyzed for cholinesterase activity, and urine samples were analyzed for metabolites of organophosphorus and carbamate pesticides. Reductions of >or= 15% from an individual's highest value were identified and considered evidence of meaningful cholinesterase activity depression.

RESULTS

The average cholinesterase activity levels were lowest in June, with significantly higher mean values in July and August. When adjusted for age, sex, minutes waited to shower, and days worked in the fields, the number of organophosphorus and carbamate pesticides detected in urine predicted reductions in cholinesterase activity.

CONCLUSIONS

These data demonstrate that workers are experiencing pesticide exposure. Greater enforcement of existing safety regulations or strengthening of these regulations may be warranted. This study demonstrates that serial measurements of cholinesterase activity across an agricultural season can detect exposure to pesticides among field-workers.

"Pesticides protect the fruit, but not the people": using community-based ethnography to understand farmworker pesticide-exposure risks

OBJECTIVES

We used community-based ethnography and public health risk assessment to assess beliefs about pesticide exposure risks among farmworkers in the Lower Yakima Valley of Washington State.

METHODS

We used unstructured and semistructured interviews, work-site observation, and detailed field notes to gather data on pesticide exposure risks from 99 farmworkers.

RESULTS

Farmworkers' pesticide-relevant beliefs and attitudes could be grouped into 5 major themes: (1) dry pesticides are often perceived as a virtually harmless powder, (2) farmworkers who identify themselves as allergic to pesticides are more acutely affected by exposure, (3) the effect of pesticide exposure is more severe for those perceived as physically weak, (4) protective equipment is used selectively in response to financial pressure to work rapidly, and (5) some farmworkers delay decontamination until they find water deemed an appropriate temperature for handwashing.

CONCLUSIONS

We elucidated farmworkers' pesticide-relevant beliefs regarding perceived danger and susceptibility to pesticides, the need to put safety second to financial considerations, and reasons for delaying decontamination. Researchers and policymakers should incorporate these data in study designs and legislation concerned with farmworker exposure to pesticides.

Seasonal variation in the measurement of urinary pesticide metabolites among Latino farmworkers in eastern North Carolina

This analysis describes the detection of urinary pesticide metabolites for Latino farmworkers across the agricultural season. Two hundred and eighty four farmworkers were recruited from 44 camps in eastern North Carolina in 2007. Data were collected at one month intervals for a total of 939 data points. The OP insecticide metabolites 3,5,6-trichloropyridinol (46.2%), malathion dicarboxylic acid (27.7%), and para-nitrophenol (97.4%); the pyrethroid metabolite 3-phenoxybenzoic acid (56.4%); and the herbicides 2,4-D (68.1%), acetochlor (29.2%), and metolachlor (16.9%) were found in sizable percentages of the samples. The percentage of farmworkers for whom metabolites were detected varied across the agricultural season. None of the farmworker characteristics were significantly associated with the detection of any pesticide metabolite. Seasonality overrides the effects of other farmworker characteristics in predicting detection of pesticide urinary metabolites. Future research needs to collect multiple exposure measures at frequent intervals over an extended period to characterize factors associated with exposure.

Migrant farmworker field and camp safety and sanitation in eastern North Carolina

Migrant farmworkers are exposed to numerous workplace hazards, with pesticides being a ubiquitous occupational exposure. This analysis describes farmworker experiences of field and camp safety conditions and their safety behaviors, and delineates farmworker characteristics associated with safety conditions and behaviors. Data were collected from 255 migrant farmworkers up to 4 times at monthly intervals during the 2007 agricultural season in eastern North Carolina. Measures assess field safety conditions and camp sanitation required by federal and state regulations. Most of the farmworkers were Latino men from Mexico. About 20% had not received pesticide safety training across the season; many of those who received such training did not understand it. Water for washing was not available for about one-third of the workers; soap and towels were not available for over half. About 20% lived in camps with more than eight workers per showerhead and about 20% lived in camps that failed to meet the standard of 30 or fewer workers per washtub/washing machine. Important predictors of variation included H2A visa status and years of experience. Four themes emerged from the analysis: (1) safety regulations are not consistently met; (2) farmworkers do not always practice safety behaviors; (3) camps become more crowded and less compliant during the middle of the agricultural season; and (4) workers with H2A visas experience better conditions and practice more safety behaviors than do workers who do not have H2A visas. Further research needs to account for social and cultural factors. Regulations should be compared with pesticide metabolite levels to measure their effectiveness. More effort is needed to enforce existing regulations.

Community-based intervention to reduce pesticide exposure to farmworkers and potential take-home exposure to their families

The US EPA Worker Protection Standard requires pesticide safety training for farmworkers. Combined with re-entry intervals, these regulations are designed to reduce pesticide exposure. Little research has been conducted on whether additional steps may reduce farmworker exposure and the potential for take-home exposure to their families. We conducted an intervention with 44 strawberry harvesters (15 control and 29 intervention group members) to determine whether education, encouragement of handwashing, and the use of gloves and removable coveralls reduced exposure. Post-intervention, we collected foliage and urine samples, as well as hand rinse, lower-leg skin patch, and clothing patch samples. Post-intervention loading of malathion on hands was lower among workers who wore gloves compared to those who did not (median=8.2 vs. 777.2 microg per pair, respectively (P<0.001)); similarly, median MDA levels in urine were lower among workers who wore gloves (45.3 vs. 131.2 microg/g creatinine, P<0.05). Malathion was detected on clothing (median=0.13 microg/cm(2)), but not on skin. Workers who ate strawberries had higher malathion dicarboxylic acid levels in urine (median=114.5 vs. 39.4 microg/g creatinine, P<0.01). These findings suggest that wearing gloves reduces pesticide exposure to workers contacting strawberry foliage containing dislodgeable residues. Additionally, wearing gloves and removing work clothes before returning home could reduce transport of pesticides to worker homes. Behavioral interventions are needed to reduce consumption of strawberries in the field.