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

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.

Risk perception and use of personal protective equipment (PPE) in pesticide use: does risk shape farmers' safety behavior?

Risk perception and use of personal protective equipment (PPE) in pesticide use were studied in 109 farmers of northern Greece. Farmers differed in the levels of pesticide risk perception, with 26.6% showing very low and low levels, 34.9% showing moderate levels, and 38.5% showing high and very high levels. Pesticide risk perception was positively correlated with education and large cultivated area, but negatively with age and non-farming as a main profession. Most farmers (82.6%) showed adequate use of PPE (mostly face mask and gloves). The use of PPE was positively correlated with education and risk perception, but negatively with age and non-farming as a main profession. Farmers with high levels of risk perception used 1.3 and 2.6 times more PPE items than those with moderate and low levels of risk perception, respectively. High education was a positive predictor, whereas main profession other than farming was a negative predictor of PPE use.

Health-Related Challenges and Programs Among Agriculture Workers: A Narrative Review

Agriculture is one of the most hazardous occupations, with many workers experiencing occupational accidents and ill health. The misuse of toxic substances, often due to inadequate protective measures, raises concerns about both individual and nature safety. However, the strenuous tasks done by the agricultural workers, especially those related to pesticide exposure and some challenges affect the farmer's health and well-being. This review paper used databases like PubMed and Google Scholar to elaborate this. English language studies are included and other languages are excluded. The health system for agricultural labour in India sheds light on the neglected status of agricultural workers and emphasizes the need for health promotion programs. For that, training and interventions are important as crucial elements in reducing pesticide exposure, with a call for the enforcement of existing laws and regulations. Agriculture workers have a proper knowledge and attitude towards the safety and program to overcome the health-related conditions they face. This paper also addresses the practices of personal protective equipment (PPE) and the challenges faced by farmers in adopting adequate safety measures.

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.

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.

Using the Socio-Ecological Model to Frame the Influence of Stakeholders on Cocoa Farmers' Pesticide Safety in Nigeria: Findings from a Qualitative Study

PURPOSE

The aim of this study was to explore the roles of stakeholders on cocoa farmers' safe pesticide use in Nigeria using the socio-ecological model as the theoretical framework.

METHODS

This was a cross-sectional qualitative study where participants were purposefully selected based on some criteria. Then, they were interviewed in-depth using a semi-structured interview approach. The interview guide was designed based on other literature and the study objectives. The interview transcripts were transcribed verbatim and analyzed using the content analysis technique.

RESULTS

In all, 57 participants were involved in the interview process across all the study locations. Five layers of influence (cocoa farmers, pesticide retailers, extension officers, pesticide importers and government agencies) were considered. At individual level, cocoa farmers complained about lack of information from other stakeholders regarding pesticide use except retailers due to the farmers' proximity to their stores. However, pesticide safety information from the retailers were found to be inadequate due to their interest in financial gains rather than a focus on human health and the environment. Additionally, most retailers had no understanding about the characteristics of products they sold as they could not read pesticide labels. Furthermore, lack of motivations, human resources and facilities hindered effective extension education in the rural communities. Also, pesticide importers took efforts to train the farmers within their network, but majority of these trainings focused on lead farmers who were expected to disseminate the information to others. Besides, the agencies did organize training or workshop sometimes, but it was inadequate due to budget constraint. Lastly, environmental or agri-policies relating to Nigerian cocoa farmers concerning safe pesticide use and disposal were also inadequate.

CONCLUSION

Generally, there was a large information gap with respect to pesticide safety between cocoa farmers and other stakeholders which undermined pesticide use safety. This study highlighted the need for government agencies in Nigeria to develop mechanisms to monitor information exchange among other stakeholders and cocoa farmers with respect to safe pesticide use and disposal.

A Comparison of Pesticide Risk Beliefs between Farmers and Farmworkers: Implications for Risk Communication and Education

Understanding the multi-dimensional risk beliefs of agricultural audiences allows risk communicators and educators to target those beliefs to improve practices. This study was designed to assess pesticide risk beliefs among English-speaking farmers and Spanish-speaking farmworkers and to compare their beliefs. The Pesticide Risk Beliefs Inventory (PRiBI) is a 19-item quantitative instrument used to assess the alignment of risk beliefs with those beliefs of experts in the field. A higher score on the PRiBI relates to an agreement with expert beliefs regarding pesticide risk. Farmers' and farmworkers' scores were signficiantly different on items corresponding to the use of physical properties to determine risk and specific adverse health outcomes associated with pesticide exposure. With an understanding that farmworkers rely on the physical properties of pesticides to assess risk, educators and farmers can encourage more reliable ways to assess pesticide hazards.

Coronavirus pandemic highlights critical gaps in rural Internet access for migrant and seasonal farmworkers: a call for partnership with medical libraries

Migrant and seasonal farmworkers, who are essential workers in the coronavirus global public health emergency, face unique risks to their health as well as longstanding health inequities. This commentary highlights these risks and argues that Internet access represents an underappreciated but critical part of the public health response. The authors first discuss the unique risks farmworkers face. We note the importance of Internet access in the time of physical distancing, the fact that many health outreach workers are no longer visiting camps, the need for telemedicine infrastructure, and the role of Internet access in providing connections to families in communities of origin. We describe existing efforts that have been implemented in North Carolina to raise awareness among public health and health promotion practitioners and researchers. The current coronavirus pandemic demands the attention of medical libraries, public health practitioners, and policy makers to address the digital divide for farmworkers and their families.

Factors affecting use of personal protective equipment and pesticide safety practices: A systematic review

An evidence-based understanding of factors influencing PPE use and pesticide safety practices has the benefit of facilitating the design of interventions to minimize exposure to pesticides and the promotion of the utilization of PPE and safety practices among agricultural pesticide handlers. The aim of this study, therefore, is to review the available literature on the use of PPE in agricultural pesticide handlers in world regions, and also the factors associated with the use of PPE and pesticide safety practices in farmers and farm workers. Full-text articles published on PubMed, Scopus, and ISI databases between 1999 and 2019 were reviewed and the scientific evidence was evaluated. One hundred and twenty-one articles were eligible for inclusion in this quantitative synthesis: 110 evaluated PPE use in agricultural pesticide handlers, and 23 focused on factors affecting PPE use and pesticide safety practices. Considerable evidence was found to show that the most basic PPE worn among pesticide handlers in all world regions was a long sleeve shirt (66.1%), long sleeve trousers (71.1%), and a hat (47.3%). The lowest basic PPE worn was an apron (8.6%), goggles (24.3%), gloves (40.5%), boots (42.3%), and mask (43.2%). The PPE worn (except for an apron) was proportionally higher in farmers than in farm workers. There is considerable evidence to suggest that the significant determinants associated with PPE use and pesticide safety practices are as follows: (1) demographic factors (i.e. education/literacy level, experience of illness, income); (2) farm structure factors (i.e. farm size); (3) behavioral and psychosocial factors (i.e. contact with pesticides, perceptions, attitudes, awareness, norms and beliefs); and (4) environmental factors (i.e. information about pesticides, access to extension services, training program, and farm organization). Therefore, there is a recognizable need for a life-long education program with training to change the perception and behavior of pesticide handlers sustainably.

Nursing Assistants' Use of Personal Protective Equipment Regarding Contact With Excreta Contaminated With Antineoplastic Drugs

PURPOSE

To examine the feasibility of observing and interviewing nursing assistants about handling of antineoplastic drugs contaminated with excreta, acceptability of a measure of personal protective equipment (PPE) use with nursing assistants, and predictors of PPE use.

PARTICIPANTS & SETTING

27 nursing assistants in an inpatient hematology-oncology unit at an academic medical center in the southeastern United States.

METHODOLOGIC APPROACH

This was an exploratory, multimethod study using observation, verbally administered questionnaires, and interviews. Research variables included recruitment rates, acceptability of observation, and understandability of a safe-handling instrument.

FINDINGS

Observed use of double gloves, chemotherapy gowns, and face shields was low; use of plastic-backed pads when flushing excreta was high.

IMPLICATIONS FOR NURSING

Nursing assistants are willing to participate in research. Standardized training and education about PPE use are needed.

Acute pesticide poisoning and related factors among farmers in rural Western Iran

Although acute pesticide poisoning (APP) is known to be a major health concern among farmers in developing countries, knowledge of its prevalence and risk factors is limited. The purpose of this study was to investigate the prevalence and a broad range of potential work-related risk factors of APP among Iranian farmers and farm workers. This cross-sectional study was conducted in rural areas of the Twiserkan County in Iran. In this study, there were 474 farmers and farm workers who had used pesticide 1 week before data collection. Participants were selected from 104 villages. Data were gathered using a questionnaire and analyzed using STATA (version 14.2 SE). Binary logistic regression and multinomial logistic regression were employed. The results of this study showed that 286 (60.3%) farmers and farm workers who applied pesticides suffered from work-related APP. Most frequent APP symptoms were runny nose (29.8%) and headache (25.1%). Five risk factors were identified, including annual income ( p < 0.05), number of farming years (odds ratio (OR) = 0.31), number of spraying years (OR = 2.40), place of pesticide storage (OR = 2.69), and type of sprayer ( p < 0.05). The results of this study indicated that APP is prevalent among the studied farmers. Some work-related factors play an important role in APP among Iranian rural farmers. In addition, the magnitude of these risk factors differed significantly by severity of acute and somatic pesticide poisoning.

Occupational predictors of urinary dialkyl phosphate concentrations in Mexican flower growers

Background Flower growers have high potential for exposures to pesticides. Occupational factors, such as tasks performed, the production method (organic or conventional), the use of personal protective equipment (PPE), and workplace characteristics influence the intensity of pesticide exposure. Objective To evaluate occupational characteristics affecting urinary concentration of dialkylphosphate (DAP) metabolites of organophosphate pesticides among a group of Mexican floricultural workers. Methods A questionnaire was administered to 117 workers who also provided a first morning urine sample. According to tasks performed and the production methods, pesticide contact was defined as low, medium, or high. PPE use was categorized as acceptable, fairly acceptable, and unacceptable. Urinary concentration of DAP metabolites were determined using gas-liquid chromatography. Association between occupational characteristics and DAP urinary concentrations was assessed by means of linear regression models. Results After adjusting for potential confounders, the workers in the medium and high contact categories had significantly higher DAP concentrations than those in the low contact category (β: 0.3, CI 95%: 0.1-0.5). Greenhouse workers had greater DAP concentrations than outdoors workers (β: 0.3, CI 95%: 0.1-0.5). Compared with non-acceptable use of PPE, acceptable use of PPE was associated with lower DAP concentrations (β: -0.4, CI 95% -0.6 to -0.1). Conclusion Improved safety training is needed for correct PPE usage, especially among flower growers who use conventional pest control methods and who work in a greenhouse environment.

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.

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.

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.