PILAR A. PARRA
Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
Agricultural work accounts for half of the labor force in the world, but in advanced industrialized countries it is much less than 10%. Agricultural work with mining and construction are considered the three most dangerous occupations worldwide. In 2005, the highest incidence of fatal (13 deaths per 100,000) and nonfatal accidents at work (about 6,700 per 100,000) were among skilled agricultural and fishery workers
There is no accurate census of hired agricultural workers. Epidemiological research that aims to report their health status is limited by the absence of a reliable numerator and cross-sectional assessments of health outcomes. Quality of data collection by fatalities and injury by occupation varies by country. Data on the health status of agricultural workers is reported by occupation, and includes farmers and family members as well as hired workers. The temporary and transient characteristic of the hired farmwork-force makes it difficult to present an assessment of their health status. This entry will focus on migrant farmworkers in industrialized countries where more reliable and recent data can be found.
Migrant farmworkers are part of the hired agricultural force, defined as “a worker temporarily engaged during harvesting periods, who come from other regions in the country or neighboring countries.”
Agricultural workers' health, in general, is negatively affected due to occupational risks and labor conditions. Occupational risks include use of heavy machinery and sharp tools, lifting heavy weights, long repetitive movements, exposure to pesticides, and working under adverse weather conditions. In many countries, labor laws protecting workers in other industries exempt agricultural workers. Comprehensive legislation on occupational safety and health is limited and poorly enforced. Cultural and language barriers add to the likelihood of injury and disease when workers do not receive adequate training in the use of machinery or pesticides.
In the European Union (EU), year-around, seasonal and migrant wage earners account for approximately 40% of persons involved in agricultural work. The EU employs 4.5 million seasonal and migrant workers, and about half a million come from countries outside the EU. Migrant workers in agriculture there are entitled to some protections. The International Labor Organization (ILO) since 1982 promoted Convention No. 184 that specifically states that “measures shall be taken to ensure temporary and seasonal workers receive the same health safety and protection and adequate and appropriate training… taking into account their level of education and differences in language.” France, with one of the largest agricultural workforces in the European Union, has health coverage for 98% of farmers and agricultural workers. However, farmers, due to the high Page 1090 | Top of Articlecosts of social contributions, may not list hired migrant workers on their payrolls. Greece, Italy, and Spain also include some protections, but temporary workers are many times excluded.
In 2007, the US census reported three million people working in agriculture, where 1.1 million were hired farmworkers and about half a million were migrant farmworkers, who migrate from their homes to a single location, crossing state lines or an international border. Only 12% are follow-the-crop migrants and will work in several farms following specific geographical streams.
Among developed nations, the USA has the largest proportion of seasonal and migrant farmworkers who are foreign born (80%) and more than half lack working permits. In the European Union, one in ten workers comes from countries outside of the EU, and unauthorized workers account for a relatively small proportion of migrant farmworkers. In general, foreign-born migrant workers in the European Union and in the USA face more obstacles in obtaining health care due to access, high costs, transportation, language barriers, and legal status.
Access to Health Services
Since 1962, the US government established health coverage under the Migrant Health Act for migrant agricultural workers, and later in 1970 included seasonal workers. Health coverage for migrant farmworkers in the USA is restricted to accidents and illness at the workplace. Access to services is further limited due to the relatively small number of Migrant Health Centers in the nation. In 2008, there were about 500 Migrant Health Centers nationwide, and cover about one quarter of all migrant and seasonal farmworkers and their families.
Occupational Risk: Fatalities and Injuries at the Work Place
In the USA, agricultural workers overall account for 3% of the workforce but were 7.4% of work-related casualties. Data from 1996 to 2006 Department of Labor's Census of Fatal Occupational Injuries for the agricultural sector report that fatality rates increased from 22.2 to 29.4 per 100,000 workers. In 2007, there were 25.7 deaths per 100,000 in agriculture compared to an average rate of 3.7 deaths in other industries. As the number of foreign born increased in the farm workforce, so did the number of fatalities. In farming and forestry, 84 deaths occurred in 1992, a sharp increment of 54% by 2002. Many of these fatalities are the result of lack of training and difficulties following instruction for lack of English language.
Governments have implemented rules and guidance on substances that can be used in agriculture. Pesticides are applied to prevent, destroy, or mitigate any pest, including insects, mice, and other animals, and weeds, fungi, and some microorganisms. In the USA, the Environmental Protection Agency regulates pesticide safety training for workers. Safety measures are not always enforced and language barriers impede full understanding of handling of pesticides with safety. Inhalation, ingestion, and absorption by the skin are ways through which pesticides can enter the body. Fields may not have available the sanitation facilities to wash themselves and their contaminated clothes. Under these conditions, pesticides can be brought home and affect workers' families, especially children. Also farmworkers' housing is exposed to drifts of pesticide applications in nearby fields. Immediate effects of smaller doses of pesticides include rash, dizziness, nausea, vomiting, eye irritation, headache, and muscle weakness. Long-term effects include increased risks of several cancers, sterility and neurological decline in adults, and other chronic health problems such as respiratory problems, memory disorders, and dermatological conditions. Pregnant women who are exposed face the danger of spontaneous abortion and deformed babies, and retarded neurobehavioral development in children.
Heat and Sun Exposure
Heat stress is an occupational risk that is the result of long hours under the sun and great physical exertion that causes body heat to rise, and if not attended to can lead to dehydration, electrolyte imbalance, neurological impairment, multi-organ failure, and death. Crop workers have a heat-related death rate of 0.39 per 100,000 workers compared to 0.02 for other civilian workers. These deaths could be easily avoided if appropriate clothing, shade, breaks, and drinking water were readily available in the fields. The 2005 National Page 1091 | Top of ArticleAgricultural Workers Survey reported that one in five workers did not have access to drinking water and cups.
Farmwork requires constant bending, climbing, crawling, twisting, overexertion, repetitive motions, excessive loads, and carrying heavy items. Moreover, because most are paid by piece rate, workers are pushed to labor for long hours, with no breaks and at high speed. All these factors increase the likelihood of injury. There are two main groups of musculoskeletal injuries: (a) peripheral neuropathies, e.g., carpal tunnel syndrome and (b) tendonitis. Others include strains and muscle pain, rotator cuff injuries, and bursitis. These disorders account for half of all agricultural occupational injuries and 30% of absences. Also, inadequate tools play a role in their injuries. These problems can be reduced by altering work procedures and by redesigning agricultural tools (ergonomics). Musculoskeletal injuries not attended may become a permanent disability.
Other serious health conditions that are more difficult to diagnose and implement a follow-up treatment are mental health and chronic conditions. These conditions are exacerbated by the isolation, job insecurity, long periods of family separation, and poverty. Health centers report increasing numbers of severe mental stress and depression and chronic conditions such as hypertension and diabetes.
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