Key Staff: Giulia Earle-Richardson. Christine Mason, Tucker Slingerland, Melisa Miles, Dr. John May

Funding Source(s): National Institute for Occupational Safety and Health (NIOSH)

Status: Completed Research Project

Project Details

Data collection from farmworker medical charts is nothing new to many of the health centers in New York and Pennsylvania. Beginning in 1997, a pilot study was conducted to get preliminary injury and illness information and to see if a health center-based surveillance model could work. Between 1997 and 1999, case reports of farmworker occupational injury or illness were collected from migrant health centers in New York and Pennsylvania. In all, 693 medical visits were reported, representing 517 cases of injury or illness, involving a total of 473 workers.

This preliminary data indicated that within the study region strains, falls and being struck by an object were the most common occurrences. The following table shows the leading sources of injury or illness.

Strains The most common locations of strain were the back (21%) and the shoulder (9%). The most common associated factors for strain were overuse (55%) and holding and awkward position (29%). Strain was found in all commodity groups. While strain is often considered by workers to be constantly present and unavoidable, the fact that it was the most common medical complaint for those seen at health centers indicates that it is interfering enough with farmworkers' ability to work that they are taking time out to seek medical care. This certainly warrants further research into the causes of strain.

Falls The second leading injury was falls. Most of these (86% or 79) occurred in apple orchards, and just over half 55%, 52 were serious enough to have gone to the emergency room. In New York, the commodity relationship with apples was clear; however in Pennsylvania injured workers from orchards did not report equally large numbers of falls. From this preliminary data it was unclear whether this represents a difference in injury experience or simply a state difference in the types of injuries seen at the migrant health centers.

Poison ivy Poison ivy was reported in 10% of the cases. This was predominantly in orchards (92% (n=45)) and disproportionately found in Pennsylvania. Fifty-nine percent of cases involved visiting the health center, suggesting relatively severe cases, since a health center medical visit often includes lost work time.

Being struck by object These accounted for 8% of cases (43), occurring mostly in orchards, (77%), and most commonly through an eye injury due to a branch strike (43%). Fifty-one percent of object strike cases went to the emergency room.

Pesticide exposure Conditions related to acute pesticide exposure were the seventh leading type, accounting for three percent of all cases. This was somewhat smaller than anticipated. At this point it is not known whether the large representation of orchards in comparison to ground crops might account for this, or whether other classification or diagnosis issues may have affected the rates. There were a relatively large number of cases (10), in which the provider could not determine whether an upper respiratory allergic reaction was in response to natural or chemical (possibly pesticide) allergens.

Commodity It is important to note that in this pilot, workers from orchard regions were much more heavily represented in the case data, most likely because the regions involved had large apple crops. Further study is needed to determine the relative size of the apple workforce in these regions to other crops, but until that data is available it would be erroneous to conclude that apple work is more hazardous than other commodities.