Growth of the Spanish-speaking workforce in the Northeast dairy industry

Dairy workers' attitudes toward dairy cattle euthanasia

Implementing timely and humane euthanasia in dairy farms remains a critical concern. One of the possible barriers for the implementation of timely euthanasia on-farm is dairy workers' attitudes toward the act. The objectives of this study were to investigate dairy workers' attitudes toward dairy cattle euthanasia and their association to individuals' demographic characteristics. A total of 81 workers from 30 dairy farms (ranging in size from less than 500 to more than 3,000 cows) participated in the survey and most participants were caretakers (n = 45; 55.6%) or farm managers (n = 16; 19.8%), with an average work experience of 14.8 years. Dairy workers' attitudes toward dairy cattle (empathy affect, empathy attribution, and negative attitudes about cattle), working environment (relying on others, perceived time constraints) and euthanasia decision-making (feeling comfortable with euthanasia, feeling confident, seeking knowledge, using different sources to obtain advice, having negative attitudes about euthanasia, having insufficient knowledge, having trouble deciding when to euthanize and avoiding if possible) were identified and used for cluster analyses. Cluster analyses identified 3 distinct clusters: (1) confident but uncomfortable with euthanasia (n = 40); (2) confident and comfortable with euthanasia (n = 32); and (3) unconfident, lacking knowledge and detached from cattle (n = 9). Dairy workers' demographic characteristics (age, sex, race and ethnicity, dairy experience, role on-farm, farm size, and previous euthanasia experience) were used as predictors for the risk factor analyses. The risk analysis demonstrated that there were no predictors for cluster 1, but White workers (P = 0.04) and caretakers that had previous euthanasia experience tended to be more likely to be members of cluster 2 (P = 0.07) whereas respondents that worked in farms with 501-1,000 cows were more likely to be grouped in cluster 3. This study provides vital information about variability in dairy workers' attitudes toward dairy euthanasia as well as its association with race and ethnicity, farm size, and previous euthanasia experience. This information can be used to implement appropriate training and euthanasia protocols to increase both human and dairy cattle welfare on-farm.

Interactive euthanasia training program for the dairy industry: Implementation and perceived respondent knowledge change

This study described the development of an interactive euthanasia training program and its potential to improve dairy workers' perceived euthanasia decision-making skills and awareness of timely euthanasia by using a survey instrument before and after the program. Training material encompassed euthanasia information over 2 production stages (calves and cows or heifers) and material was delivered on-farm in a case-scenario format (14 cases). During a 3-mo period, 30 different dairy farms were visited and 81 participants were enrolled in this study. Each participant was required to complete a survey pretraining, to complete the case studies from the production stage in which their job responsibility was more closely aligned with (estimated completion time of 1 h), and to complete a survey post-training. Surveys contained 8 statements regarding participants' perceived knowledge of euthanasia practices. The questions were answered on a 5-point scale: (1) strongly disagree, (2) disagree, (3) neither agree nor disagree, (4) agree, or (5) strongly agree. Multivariable mixed-effects logistic regression models were created for each question to investigate the effect of age, sex, dairy experience, farm size, role at the farm, race, previous experience with euthanasia, veterinarian degree, and production stage in the score change, defined by the presence or absence of an increase in the 5-point scale score. Upon completion of the training, respondents were more confident in identifying compromised animals (score change = 0.35), determining when an animal should be euthanized (score change = 0.64), and understanding the importance of timely euthanasia (score change = 0.26). Age and euthanasia experience were significantly associated with the respondents' perceived knowledge; suggesting that younger, less-experienced caretakers on-farm should be prioritized to receive training. The proposed interactive case-based euthanasia training program has proven to be valuable to dairy participants and veterinarians as it provides a means to improve dairy welfare.

Antimicrobial stewardship on the dairy: Evaluating an on-farm framework for training farmworkers

Dairy farmworkers are commonly responsible for disease diagnosis and routine treatment decisions for cattle. This highlights the importance of farmworkers' knowledge and skills to successfully implement judicious use of antimicrobials in livestock production systems. The main objectives of this project were to develop and evaluate an on-farm educational program for farmworkers in antimicrobial stewardship in adult dairy cattle. A longitudinal quasi-experimental study design was used, by enrolling 12 conventional dairy farms in the United States (6 in California and 6 in Ohio). Farmworkers responsible for treatment decisions on the farm (n = 25) participated in a didactic and hands-on 12-wk antimicrobial stewardship training program led by the investigators. All antimicrobial stewardship training materials were available in Spanish and English. Interactive short videos with audio were developed to cover the learning objectives for each of the 6 teaching modules: antimicrobial resistance, treatment protocols, visual identification of sick animals, clinical mastitis, puerperal metritis, and lameness. Pre- and post-training assessments were administered using an online training assessment tool to evaluate changes in knowledge and attitudes about antimicrobial stewardship practices. Cluster analysis and multiple correspondence analyses were conducted to evaluate the association among categorical variables for participants' level of change in knowledge and its association with language, farm size, and state. A 32% average increase in knowledge was observed through an assessment conducted after completing the antimicrobial stewardship training, compared with the pre-training assessment. A significant improvement in 7 of 13 attitude questions related to antimicrobial stewardship practices on the farm was observed. Knowledge and attitude scores of participants on antimicrobial stewardship and identification of sick animals significantly improved after completing the antimicrobial stewardship training. The results observed in this study support the relevance of antimicrobial stewardship training programs targeting farmworkers to improve antimicrobial drug use knowledge and skills.

Preliminary investigation of a hypertonic saline nasal rinse as a hygienic intervention in dairy workers

Livestock workers experience an increased burden of bioaerosol-induced respiratory disease including a high prevalence of rhinosinusitis. Dairy operations generate bioaerosols spanning the inhalable size fraction (0-100 μm) containing bacterial constituents such as endotoxin. Particles with an aerodynamic diameter between 10 and 100 μm are known to deposit in the nasopharyngeal region and likely affect the upper respiratory tract. We evaluated the effectiveness of a hypertonic saline nasal lavage in reducing inflammatory responses in dairy workers from a high-volume dairy operation. Inhalable personal breathing zone samples and pre-/post-shift nasal lavage samples from each participant over five consecutive days were collected. The treatment group (n = 5) received hypertonic saline while the control group (n = 5) received normotonic saline. Personal breathing zone samples were analyzed for particulate concentrations and endotoxin using gravimetric and enzymatic methods, respectively. Pro- and anti-inflammatory cytokines (i.e., IL-8, IL-10, and TNF-α) were measured from nasal lavage samples using a multiplex assay. Inhalable dust concentrations ranged from 0.15 to 1.9 mg/m3. Concentrations of both pro- and anti-inflammatory cytokines, specifically IL-6, IL-8, and IL-10, were significantly higher in the treatment group compared to the control group (p < 0.02, p < 0.04, and p < 0.01, respectively). Further analysis of IL-10 anti-inflammatory indicates a positive association between hypertonic saline administration and IL-10 production. This pilot study demonstrates that hypertonic saline nasal lavages were successful in upregulating anti-inflammatory cytokines to support larger interventional studies.

Predictors of Dairy Worker Pre-Test and Post-Test Performance on a Dairy Safety Knowledge Test: Impact of Education Level and Native Language

BACKGROUND

Efficacy-driven assessments of linguistically appropriate occupational health and safety training (OHS) for dairy workers remain uncommon. This study analyzes predictors of performance on a dairy safety knowledge test using pre-and-post knowledge assessments. The safety training course was delivered by iPad™ to Idahoan dairy workers, managers, and owners.

OBJECTIVE

To determine the predictors of safety knowledge scores among dairy worker course participants.

METHODS

Predictors of pre-test (baseline) scores and change in test scores of n = 1,336 participants were compared, and multivariate iterative linear regressions were used to predict test performance, adjusting for variables such as occupation, years of formal education, native language, and years in dairy work.

RESULTS

Test scores for Spanish and English speakers improved between pre-test and post-test. Years of formal education was the most predictive variable of higher baseline scores and change in test scores among dairy safety course participants, regardless of language.

CONCLUSION

Dairy worker safety training course results showed improvements in safety knowledge and test scores. Years of formal education of participants appears to be a key determinant of increases in safety knowledge, and therefore safety training programs need to address the learning needs of less educated workers.

Dairy farm worker milking equipment training with an E-learning system

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Milking equipment malfunctions, which milkers could detect, are common on dairy farms.

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Our results reaffirm the lack of communication between managers and employees, which restate the necessity to state objectives and goals on every training.

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Practical logistics of on-farm training are a limiting factor, so the use of online training is a reasonable alternative for dairy farms, increasing employees' confidence by providing more detailed training content.

In many farms, the logistics of on-farm training are a limiting factor due to communication challenges in the workplace (i.e., cultural differences, language barriers, impaired listening skills) and limited access to industry professionals. The use of E-learning systems may help to improve communication and can be sensitive to cultural challenges. The objectives of this study were to (1) identify how many of the high-priority problems in the milking parlor relate to milker training in the areas of milking equipment and milking routine, (2) design and test an E-learning training system for dairy farm milkers related to milking equipment, and (3) gain feedback targeted to improve subsequent E-learning training modules. An interactive online training course on basic checks of the milking equipment was developed with a cloud-based authoring software. A total of 95 dairy farm workers on 15 commercial dairy farms in northern New York State (USA) were trained and participated in the study. Milk quality professionals performed an initial evaluation of 3 main areas: equipment analysis, milker assessment, and cow assessment. The 3 most important risk factors for mastitis were summarized for each farm. A training event was scheduled with milkers guided by a bilingual (English and Spanish) professional in milk quality. Over 50% of the farms (8/15) had one or more of the top 3 priorities involving problems with milking equipment, which milkers could have detected and reported to management. All participants completed the module, 95% stated that they felt capable of checking the equipment before milking, and 86% felt more confident in reporting equipment problems to the manager after having taken the course. There were also differences between managers' and milkers' statements on how and whether milking equipment training was offered or not on the farm. This can be explained due to the lack of or secondary to poor communication between managers and employees on training objectives and goals on the farm. Our results also show that milking equipment issues which milkers could detect and report are common on dairy farms and reinforces the need for additional milker training in this area.

Association of Category of Cattle Exposure with Tuberculosis Knowledge among Dairy Workers in Bailey County, Texas

Objective: To determine the knowledge of tuberculosis (TB) among dairy workers in Bailey County, Texas.

Methods: A cross-sectional study design was used to collect 225 survey responses concerning knowledge of TB among dairy workers on 10 dairy farms in Bailey County, Texas. Subjects used iPad tablets to log responses to 15 demographic questions and a 17-item TB knowledge quiz, measured by: (1) TB characteristics, (2) TB transmission, (3) TB symptoms, (4) TB diagnosis, (5) TB treatment, and (6) bovine TB. A proxy for exposure, dairy workers were classified into categories of cattle exposure - high, medium, and low.

Results: Relative to the medium/low group, workers in the high group tended to be younger (32.6 (SD 11.0)), Guatemalan (52.6%), K'iche' speaking (37.8%), males (89.1%) with less years living in the U.S. (10.8 [SD 12.5]) and lower levels of formal education completed (59.6% with no formal/elementary level). Overall, the average score was 7.1 (SD 4.9) out of 17 (41.8% out of 100.0%). Relative to one another, the medium/low group (8.0 (SD 4.6) out of 17) scored better than the high group (6.7 [SD 5.1] out of 17). No significant associations were found between the category of exposure and TB knowledge score.

Conclusion: Deficiencies in TB knowledge were identified in all categories of exposure. TB training on dairy farms should include all measured tested in this study and should be administered to all workers regardless of the category of exposure.

Association of Exposure to Cattle with Self-Reported History of TB Among Dairy Workers

BACKGROUND

Mycobacterium bovis (bTB) is a potential health hazard to dairy workers. This study uses the One Health wholistic framework for examining bovine tuberculosis (TB) and its relationship to human health. This approach can help bridge surveillance data gaps and contribute to disease control and prevention programs for dairy farm workers, cattle, and the environment. The primary objective of this study was to compare the self-reported history of TB among dairy workers in Bailey County, Texas, with occupational categories of risk and exposure to TB.

METHODS

A cross-sectional study was conducted among dairy workers. Job positions were used as a proxy for exposure to cattle-high and medium/low. We employed bivariate analyses to examine differences between groups using both the chi-square test and the nonparametric Kruskal-Wallis test.

RESULTS

Of the 293 dairy workers invited, 77.0% (n = 225) participated. No statistically significant associations were found between job categories and reported history of TB exposure. Workers in the high group were younger, Guatemalan males with lower levels of formal education, more likely to be single with no children, and cohabitating with coworkers compared with the medium/low group.

CONCLUSION/APPLICATION TO PRACTICE

Self-reported TB history among dairy workers is an imprecise measure of being previously diagnosed with TB. Dairy workers at risk for occupationally acquired TB could be tested for TB before employment and tested periodically thereafter, and more expeditiously treated if a positive test is obtained. Future studies should focus on the feasibility of offering on-farm health services, such as TB screening.

Precarious Essential Work, Immigrant Dairy Farmworkers, and Occupational Health Experiences in Vermont

Migrant dairy workers in Vermont face a wide range of occupational and health hazards at work. This research examines the environmental risks, occupational health hazards, and health outcomes experienced by migrant dairy farm workers in Vermont. This research draws on a triangulation of sources including analysis of data—surveys and interviews with migrant dairy farmworkers gathered by the organization Migrant Justice since 2015 as well as relevant key informant interviews with community organizations across the state to characterize the occupational health experiences of migrant dairy workers in Vermont. Our results show that Vermont migrant dairy farmworkers received poor health and safety training and lacked sufficient protective gear. Over three quarters of the respondents reported experiencing harm from chemical and biological risks. Close to half the survey respondents reported headaches, itchy eyes and cough; a quarter reported breathing difficulties; three fourths reported being hurt by animal-related risks. These exposures and existing health concerns are avoidable. Migrant workers require better social representation and advocates to negotiate better work-related protection and training, access to health services, and social welfare to ensure their health and safety.

Bovine Tuberculosis Case Intervention Using the T.SPOT.TB Assay to Screen Dairy Workers in Bailey County, Texas

Background: One potential exposure on a dairy farm is Mycobacterium bovis or bovine tuberculosis (bTB)-an infectious zoonotic pathogen. The prevalence of tuberculosis among dairy workers in the U.S. is unknown largely due to insufficient surveillance and testing practices. Our objective was to determine the prevalence and risk factors of LTBI among dairy workers potentially exposed to cattle infected with bTB in two Bailey County, Texas dairy farms in 2016. Methods: This study involved a secondary analysis of data that were collected by Texas Department of State Health Services (DSHS) Public Health Region 1 (PHR 1). A total of 140 dairy workers were tested using the T.SPOT.TB test assay. As a proxy for occupational exposures, we used three categories of cattle exposure groups based on work task, duration, and conditions of exposure to cattle-high, medium, low. Results: Positive LTBI was found among 14/140 (10.0%) of the dairy workers tested with 12/87 (13.8%) in Dairy A and 2/53 (3.8%) in Dairy B. All LTBI cases were determined to be from Hispanic workers with 71.4% indicating having been vaccinated with the BCG vaccine in their country of birth and none indicated previously known exposure to TB. The high category of cattle exposure group experienced the highest prevalence of LTBI (64.3%), followed by the medium cattle exposure group (28.6%), and the low cattle exposure group (7.1%). Conclusion: Our findings suggest that the prevalence of LTBI among dairy workers in Bailey County, Texas is higher than demographically comparable workforces. Future efforts should focus on the development, delivery, and evaluation of a tuberculosis-and other zoonotic diseases-health and safety training which can become a part of a more comprehensive safety management and training program on dairy farms.

Effects of an 8-Week Dairy Production Medicine Course on Veterinary Student Self-Confidence and Perceptions of Knowledge and Skills Used by Dairy Veterinarians

The 8-week dairy production medicine course at the National Center of Excellence in Dairy Production Medicine Education for Veterinarians is designed to equip senior veterinary students with the knowledge and skills needed to serve the dairy industry. Course developers identified 59 topics of importance for dairy production medicine veterinarians. Students (N = 50) were surveyed before and after the course to determine their perceptions of (a) the importance of the 59 topics for their intended positions and (b) their knowledge and skill in those areas. We expected the course to affirm or strengthen perceptions of importance and increase confidence. Students rated 57 of the topics as moderately or very important before the course. Ratings were unchanged (56 topics) or increased (3 topics) after the course. Before the course, students believed they had a lot of knowledge and skill in just one area: animal behavior and handling. At the end of the course, students believed they had a lot of knowledge and skill in 21 areas; confidence ratings were higher for 47 of the 59 topics. Alumni were surveyed 1-2 years after graduation to determine the importance of the 59 topics to their positions, their impressions about how well the course prepared them in those areas, and whether they referred back to course materials. Feedback was used to adjust the course. The topics alumni rated as most important were similar to those students predicted would be most important. Seventy-five percent of alumni used the course website as a resource in practice.

Using mobile technology to increase safety awareness among dairy workers in the United States

BACKGROUND

Modern U.S. dairy farm operations present multiple safety hazards which may result in worker injuries, illnesses and fatalities. The U.S. industry trend towards large-herd milking operations, especially in the Western U.S., necessitates an increased number of workers on each farm. The U.S. dairy workforce is comprised of an increasing percentage of immigrant workers with limited English proficiency which presents a safety training challenge. Our objective was to develop, deliver and evaluate safety awareness training to U.S. dairy farm workers using mobile tablets as a personal learning environment.

METHODS

A non-random sample of 1,436 dairy workers received safety awareness training on a mobile device platform. Kirkpatrick Levels 1, 2 and 3 training effectiveness evaluations were performed.

RESULTS

Approximately 58.7% of training participants received a middle school education, and 22.7% were from Guatemala who reported K'iche' as their native language. A statistically significant large effect size suggests safety knowledge was gained among training participants when comparing post-test scores to pre-test scores (Level-2). Training participants rated their training experience favorably (Level-1), and applied knowledge gained in their daily work activities three months after training (Level-3).

CONCLUSION

Our findings suggest the utilization of mobile learning techniques is an effective means to deliver safety awareness training content to dairy workers. Dairy worker safety training should be culturally, linguistically, and literacy appropriate and comprehensive in nature to include all applicable dairy safety hazards. Our observations support the use of mobile devices as just one component of a more comprehensive health and safety management program on farms.

Changes in work characteristics over 12 years: Findings from the 2002-2014 US National NIOSH Quality of Work Life Surveys

OBJECTIVES

To assess changes in work characteristics, socioeconomic status inequalities in changes in work characteristics, and whether US workplaces are becoming more stressful.

METHODS

We analyzed data from 5361 employed participants from the 2002, 2006, 2010, and 2014 NIOSH Quality of Work Life Surveys, based on representative samples of US workers. We used regression analyses to assess changes in job characteristics, adjusting for age, sex, race/ethnicity, education, work hours, and unemployment rate. For the regression analyses with continuous job characteristics, we created standardized variables allowing for the magnitude of changes to be directly compared between job characteristics.

RESULTS

Over the period 2002-2014, we observed statistically significant increases in job strain (+0.09 standard deviations (SD), P = 0.02), low job control (+0.10 SD, P = 0.03), and work-family conflict (+0.15 SD, P = 0.001). No significant changes were observed for high job demand, low social support, and low reward. The largest increase in low job control was seen among service workers.

CONCLUSIONS

The increase in two cardiovascular disease risk factors, job strain, and low job control, might partially explain the slowing of the decline in US heart disease and stroke mortality rates.

A Guide to the Design of Occupational Safety and Health Training for Immigrant, Latino/a Dairy Workers

Industrialized dairy production in the U.S. relies on an immigrant, primarily Latino/a, workforce to meet greater production demands. Given the high rates of injuries and illnesses on U.S. dairies, there is pressing need to develop culturally appropriate training to promote safe practices among immigrant, Latino/a dairy workers. To date, there have been few published research articles or guidelines specific to developing effective occupational safety and health (OSH) training for immigrant, Latino/a workers in the dairy industry. Literature relevant to safety training for immigrant workers in agriculture and other high-risk industries (e.g., construction) was examined to identify promising approaches. The aim of this paper is to provide a practical guide for researchers and practitioners involved in the design and implementation of effective OSH training programs for immigrant, Latino/a workers in the dairy industry. The search was restricted to peer-reviewed academic journals and guidelines published between 1980 and 2015 by universities or extension programs, written in English, and related to health and safety training among immigrant, Latino/a workers within agriculture and other high-risk industries. Relevant recommendations regarding effective training transfer were also included from literature in the field of industrial-organizational psychology. A total of 97 articles were identified, of which 65 met the inclusion criteria and made a unique and significant contribution. The review revealed a number of promising strategies for how to effectively tailor health and safety training for immigrant, Latino/a workers in the dairy industry grouped under five main themes: (1) understanding and involving workers; (2) training content and materials; (3) training methods; (4) maximizing worker engagement; and (5) program evaluation. The identification of best practices in the design and implementation of training programs for immigrant, Latino/a workers within agriculture and other high-risk industries can inform the development of more effective and sustainable health and safety training for immigrant, Latino/a dairy workers in the U.S. and other countries.

Occupational injuries on thoroughbred horse farms: a description of Latino and non-Latino workers' experiences

Animal production is a dangerous industry and increasingly reliant on a Latino workforce. Within animal production, little is known about the risks or the occupational hazards of working on farms involved in various aspects of thoroughbred horse breeding. Extant research suggests that horse workers are at risk of musculoskeletal and respiratory symptoms, kicks, and other injuries. However, limited known research has examined the experiences of the industry's workers, including immigrant workers, despite their prominence and increased vulnerability. Using data collected from thoroughbred farm representatives via a phone-administered survey, a 2-hour face-to-face semi-structured interview, and farm injury logs, this article identifies and describes types of injuries experienced by workers (N = 284) and their surrounding circumstances. Results indicate that general injuries and musculoskeletal strains, sprains, and tears account for a majority of injuries among workers on thoroughbred farms. Upper limbs and extremities are most frequently injured, while direct contact with the horse accounted for over half of all injuries. No differences in the diagnoses or distribution of injury were found by ethnicity; however, Latinos were more often struck by or trampled by a horse while non-Latinos were more often injured by an insect or plant. Implications and opportunities for future research are discussed.

Overview of immigrant worker occupational health and safety for the agriculture, forestry, and fishing (AgFF) sector in the southeastern United States

BACKGROUND

Manual labor in the Agriculture, Forestry, and Fishing (AgFF) Sector is provided primarily by immigrant workers. Limited information is available that documents the demographic characteristics of these manual workers, the occupational illnesses, injuries and fatalities they experience; or the risk factors to which they are exposed.

METHODS

A working conference of experts on occupational health in the AgFF Sector was held to address information limitations. This paper provides an overview of the conference. Other reports address organization of work, health outcomes, healthcare access, and safety policy.

CONTENTS

This report addresses how best to define the population and the AgFF Sector, occupational exposures for the sector, data limitations, characteristics of immigrant workers, reasons for concern for immigrant workers in the AgFF Sector, regulations, a conceptual model for occupational health, and directions for research and intervention.

Health status and needs of Latino dairy farmworkers in Vermont

Vermont is a new Latino destination where many Spanish-speaking migrants have found work on dairy farms. One hundred twenty Latino workers were surveyed on 59 Vermont dairy farms to develop a demographic profile and evaluate their self-assessed health status and barriers to care. The study found, similar to other studies, the majority of workers were young, male Mexicans. However, the workers in this study, as compared to others, originated farther south in Mexico and there were significant regional differences in educational attainment. Workers defined health in terms of their ability to work and the majority believed themselves to be in good health. The majority felt that moving to the United States has not changed their health status. The most common health issue reported was back/neck pain, followed by dental and mental health issues. Workers are both physically and linguistically isolated and reported isolation as the most challenging aspect of dairy farm work. Fear of immigration law enforcement was the primary barrier to care. Community-based initiatives, including partnerships with colleges and universities, outreach to farm employers and the adoption of "bias-free policing" are strategies that can increase access to health care for Latino dairy farmworkers in the United States.

Overcoming language and literacy barriers in safety and health training of agricultural workers

The workforce in all areas of United States agriculture and forestry is becoming increasingly diverse in language, culture, and education. Many agricultural workers are immigrants who have limited English language skills and limited educational attainment. Providing safety and health training to this large, diverse, dispersed, and often transient population of workers is challenging. This review, prepared for the 2010 Agricultural Safety and Health Council of America/National Institute for Occupational Safety and Health conference, "Be Safe, Be Profitable: Protecting Workers in Agriculture," is divided into five sections. First, we describe the occupational and demographic characteristics of agricultural workers in the United States to highlight their safety and health training needs. Second, we summarize current research on the social and cultural attributes of agricultural workers and agricultural employers that affect the provision of safety and health training. Worker and employer attributes include language, literacy, financial limitations, work beliefs, and health beliefs. Third, we review current initiatives addressing safety and health training for agricultural workers that consider worker language and literacy. These initiatives are limited to a few specific topics (e.g., pesticides, heat stress); they do not provide general programs of safety training that would help establish a culture of workplace safety. However, several innovative approaches to health and safety training are being implemented, including the use of community-based participatory approaches and lay health promoter programs. Fourth, the limited industry response for safety training with this linguistically diverse and educationally limited workforce is summarized. Finally, gaps in knowledge and practice are summarized and recommendations to develop educationally, culturally, and linguistically appropriate safety and health training are presented.