Northeast Community Collaboration for Farmworker Health and Safety

CDC / NIOSH Funded Project / NEC Community Based Participatory Research

Overview

The Northeast Center for Agricultural Health's (NEC) community-based partnerships are addressing important health and safety issues in diverse agricultural populations at several sites across the northeast. In most of these projects, the key effector is a "work team" composed of workers, employers and other interested parties. Work teams are organized and facilitated by staff from NEC and local partner community groups. With community input, these work teams define priority problems, select interventions, assist in the testing and evaluation of the proposed interventions and help with the dissemination of proven interventions.

NEC has found that: 1) employers and farm workers can collaborate to identify and address occupational health problems; 2) farm workers and employers both provide valuable insights into solutions from the design of implements to educational materials; 3) these types of community-based efforts can help identify other issues affecting farm worker populations.

For more information on this project, please contact Sherry Wyckoff, Research Coordinator at 800-343-7527 or swyckoff@nycamh.com.

CT CBPR

NEC partnered with University of Connecticut (UCONN) to use community based participatory research (CBPR) as a means of reducing occupational injuries experienced by farmworkers employed at shade tobacco farms in the Connecticut River Valley. Focus groups, work team meetings and other face-to- face meetings with the workers and growers identified several occupational health issues. Three farms initially joined the coalition. Medical chart review data was collected from UCONN's mobile clinic which services these farms. Skin irritation (38%), musculoskeletal pain and strain (35%), and eye irritation (14%) were the most prevalently diagnosed occupational injuries. Intervention discussions by the CBPR Work Team revealed two opposing views of why skin and eye irritation were problems  problems with worker hygiene vs. adequacy of field sanitation stations. Initial field observations and reports of workers suggested that most farms did not reliably have soap and towels available in the fields. Education of both employers and workers became a focus to address these different perspectives.

The Work Team established and developed multidimensional interventions for both growers and farm workers. The primary objective of the interventions was reduction of work-related eye and skin irritation. Interventions for farmworkers included personal hygiene training (during work in the fields and after work at their barracks) and the provision of personal protective equipment incentives (no-cost protective glasses, sweat bands, gloves and other personal protection kits). Interventions for growers focused on ways to enhance and reinforce the availability of field personal hygiene for workers. Researchers created low cost solutions for paper towel dispensers and "soap on a rope" (bar soap tied in nylon socks). One participating farm modified their water stations with more spigots for easier worker access. Follow up shows high rates of field sanitation compliance.

Since 2006, the project has trained over 1,500 farmworkers on workplace health and safety practices to reduce eye and skin irritation. During 2010, the Work Team identified the need to continue health and safety trainings on farms once the research ends, and therefore, new collaborations were sought to introduce another training intervention. The Work Team contacted Eastern CT AHEC, a group that established several effective Promotores de Salud Programs for farmworkers (community health advocate programs). These programs train workers within their community to provide public health education. Scientific literature supports the community health worker model as an effective intervention to prevent and control chronic diseases and illnesses. Promotores increase access to health and social services; deliver culturally acceptable health education and advocate for individual and community health needs. Material development and promotores training is currenty underway.

CBPR  Black Dirt Region Vegetable Farmworkers, Orange County, NY

The current community collaborations project in the Black Dirt region of Orange County, NY builds on a previously established work team. Several years ago, the community engaged in a CBPR project that focused on eye irritation. The fine soil of this region creates excellent growing conditions, however, it also is easily transferred to hands, clothing and transmitted through the air. The project work team successfully developed an intervention consisting of safety glasses, saline solution and educational materials distributed to farmworkers. Subsequent evaluation demonstrated a decrease in eye irritation.

Now, this work team has identified low back pain as the priority concern. Many agricultural tasks can influence musculoskeletal strain and pain. Awkward postures and repetitive movements associated with crop farming can lead to chronic aching muscles and pain in shoulders, backs and wrists. The primary crop grown in this area is dry onions, however, many farms have diversified crops to meet consumer needs and sustain production activity. Lettuce, squash and assorted vegetables are also being grown here. The tasks selected by the work team and its consulting ergonomist as leading causes of back pain are weeding and stacking bagged onions.

Intervention identification, development and testing is underway. Some tools can be used by farmworkers for weeding, but must be small bladed to allow precision near the plant roots to avoid damage to the plant. An interchangeable bladed hoe with several specially designed blades will be tested during the 2011 season. There are times when a tool is not feasible and workers must meticulously hand weed row after row of lettuce. For this type of work, a new wearable kneeling pad has been designed to alleviate worker discomfort and will be evaluated in 2011. Changes to the stacking process in the onion packing houses are challenging, but are being studied and intervention designs have been initiated.

CBPR  Old Order Mennonite Farm Safety Schoolhouse Trainings, Yates County, New York

This project is an educational intervention aimed at delivering agricultural safety information to Mennonite youth, grades one to eight, in their one-room schoolhouses. The purpose of this intervention is to reduce agricultural injuries and fatalities in the Groffdale Conference, an Old Order Mennonite community located in Yates County, New York.

Using the community participatory research model, NYCAMH assisted concerned community members to create a culturally appropriate farm safety presentation for Mennonite children. The educational program is delivered over a three year cycle to the 31 schools in the Groffdale Conference. Approximately a third of the schools receive the program each year. The program is delivered by members of the Yates County Farm Safety in Schools Committee. It is approximately an hour in length and utilizes a 20 page flip chart and interactive presentations. A graphically based pre-post evaluation was used to evaluate the effectiveness of the program. Each year, half of the participating schools were randomly chosen to receive a pre-evaluation and the remaining schools were given the post-evaluation. Additionally, NYCAMH safety educators and the committee members have conducted follow-up qualitative evaluations with each school one year after receiving the program.

As of spring, 2011, over 1000 school children have received this farm safety training. Pre/post testing results are mixed. Comparison of the pre-post evaluations from the first year of trainings showed statistically significantly higher scores in the post evaluation group indicating some knowledge gain. In 2010, the program was delivered to 266 students in ten schools. There was no statistical difference between the pre-post scores with this group of students. The third year of this program was delivered in January and February 2011 to the remaining ten Groffdale Conference schools. Results of the follow-up evaluation conducted with seven of the first year schools showed that most students remembered the program from the previous year and reported talking about the program with their parents. Significant changes to farm practices such as installing PTO shield guards, disallowance of extra riders and additions of fences around manure pit have been reported by the school children.

A vital aspect of this approach is that members of the Old Order community are the educators who are delivering the information in a culturally appropriate and accepted manner. As an outside organization, it is highly unlikely that NYCAMH would have access to this population to directly deliver youth farm safety education.

North Country Dairy 1st Aid Trainings

For this project, NYCAMH has partnered with the Opportunities for Oswego outreach team in Jefferson and Lewis counties in northern New York. Information regarding priority areas to address was gathered at migrant coalition meetings, farm owner interviews and farmworker focus groups. Response to farm emergencies and Hispanic farmworker knowledge of farm location to provide key information to emergency personnel is the top concern in this location.

NYCAMH already offers on farm safety trainings including certified CPR and First Aid trainings. However, these trainings can take up to three hours to complete and farmworker time constraints can limit participation. Using farm injury surveillance data currently being collected by NYCAMH, a revised emergency response training has been developed with a focus on the most common farm injuries identified by the surveillance data. These injuries include:

• Struck  equipment and animal related
• Tractor rollovers
• Falls from farm structures
• Machinery entanglement
• Tractor/equipment runovers

To address the concern of farmworker knowledge of location, NYCAMH developed an emergency information sheet that folds to business card size to carry in a wallet. The outside of the sheet contains emergency response procedures. The inside provides space for farmworkers to record contact information, farm owner data, farm location, emergency contacts and pertinent medical details such as any health conditions or current medications.

The training is currently being pilot tested and evaluation criteria are under development at this time. If you are a New York dairy farmer and interested in having this training provided to your farmworkers for free at your farm, please contact Sherry Wyckoff, Research Coordinator at swyckoff@nycamh.com or call 800-343-7527.