11 Health and Labor Intersections in Agricultural Systems
Holly Chittum and Hannah Tiffin
Introduction
Agricultural work is consistently ranked as one of the most dangerous occupations in the United States (Centers for Disease Control and Prevention, 2020). This remains true globally as well: it is classified as one of the most hazardous occupations worldwide, in line with other hazardous occupations such as construction and mining. Despite these hazards, nearly half of the global workforce is employed within the agricultural sector (International Labour Organization, 2015). The hazards that attend agricultural work are due to the work itself and the work and shelter conditions often associated with agricultural labor, as well as inequalities in protective equipment, shelter, and access to adequate healthcare.
This chapter discusses the hazards associated with farmworker labor, including the main routes of hazardous exposure: job-related injuries, chemical exposure through agrochemical handling and use, extreme working and living conditions, and disease. Common chronic diseases stemming from these four routes of exposure are briefly discussed as well.
Occupational Hazards
Job-Related Injuries
Agricultural work is physically demanding work that often requires long hours, repetitive motions, and difficult terrain and conditions. Sprains, musculoskeletal injuries, and chronic pain are some of the most common occupational injuries that affect farmworkers worldwide. The work itself can result in work-related injuries such as back and knee pain (National Center for Farmworker Health, 2015) due to the repetitive nature of certain tasks. It can also result in sprains and injuries due to hazards present on the job (International Labour Organization, 2015). Every day, 100 farmworkers in the United States suffer a lost-work-time injury. Additionally, mechanical equipment and transportation can result in severe injuries and even death. In 2017 in the United States, transportation incidents, including tractor-related events, were the leading cause of death among this population (Centers for Disease Control and Prevention, 2020).
Chemical Exposure
The use of pesticides, insecticides, and other agrochemicals is one of the most hazardous parts of agricultural labor. In fact, among all occupations in the United States, the job of farmworker has one of the highest rates of chemical injuries and toxicities (North Carolina Farmworker Institute, 2008). This is a global challenge for farmworkers and can be especially dangerous when labels are in a non-native language, proper protective clothing and training are not provided, or chemicals are mixed at unsafe concentrations or used in off-label ways.
Chemical drift can also be hazardous to workers, their families, and communities located near farms. The toxic effects of agrochemical use and pesticide exposure can manifest as skin rashes and acute symptoms such as nausea, vomiting, and burning and itching eyes. Long-term chronic health effects are frequently linked to pesticide exposure and can include serious conditions such as various cancers, neurological disorders, reproductive disorders, and mental health effects including depression (International Labour Organization, 2015; North Carolina Farmworker Institute, 2008).
Extreme Working and Living Conditions
As diverse as the agricultural sector may be, there are several common working conditions that can cause workers to be exposed to natural hazards during their workday. These include rainfall and extreme temperatures, especially high heat (North Carolina Farmworker Institute, 2008). One of the most common occupational health causes of morbidity and mortality among agricultural workers is heat-related illness. A recent study conducted in the United States reported that the agriculture, forestry, fishing, and hunting industry had a heat-related workplace fatality rate that was 35 times higher than other industries’ (Gubernot et al., 2015).
Additionally, limited access to clean drinking water and hygienic restrooms as well as substandard housing can result in unsafe working and living conditions. Housing that is overcrowded can contribute to an increased risk of infectious and parasitic diseases among inhabitants (North Carolina Farmworker Institute, 2008). These factors contribute to the higher rates of infectious diseases and parasitic infections that are seen among farmworkers compared to other populations (La Cooperativa Campesina de California, 2011). Farmworker families may also come into contact with pesticides that workers use on the job, especially when inadequate personal protective equipment and cleaning facilities exist at the worksite, potentially causing farmworkers to bring toxic substances home with them. When clean water is not provided or accessible, workers may have to resort to inadequate and potentially dangerous sources for their drinking water. This may include water that has been contaminated by pesticide runoff (North Carolina Farmworker Institute, 2008).
Vector-Borne and Zoonotic Diseases
Working outdoors puts individuals at risk of diseases that are transmitted by insects and other arthropods. Farmworkers’ disease transmission risk varies by region and the arthropods and disease organisms present in a particular area. Generally speaking, mosquitoes, other types of flies, and ticks are the primary concern in terms of vector-borne diseases. “Vector-borne” means a disease-causing organism is transmitted by a species to a new host. For example, in many regions, mosquitoes are a vector of the parasite that causes malaria in humans and other animals and are of critical concern to those who spend long hours outdoors and are thus subject to increased risk of malaria and other vector-borne diseases. In tropical and sub-tropical climates and at lower latitudes, mosquito-borne illnesses are the primary concern. However, vectors including black flies, sandflies, tsetse flies, fleas, lice, ticks, and even aquatic snails are also species of concern when discussing the transmission of vector-borne diseases (World Health Organization, 2020).
Globally, vector-borne diseases comprise more than 17% of all reported infectious diseases and cause more than 700,000 deaths each year (World Health Organization, 2020). At higher latitudes, individuals working outdoors are typically of greater risk of tick-borne diseases than mosquito-borne illnesses. A study of agricultural workers in Poland found that infectious and parasitic diseases were the most commonly seen diseases in this population, with Lyme disease, transmitted by ticks, being the most frequently reported disease (Żukiewicz-Sobczak et al., 2013).
Farmworkers are also at risk of contracting zoonotic diseases. These are diseases such as rabies and Salmonella that can be transmitted between animals and humans. This is of particular concern to farmworkers as depending on the nature of their work, they may come into frequent contact with livestock, poultry, or even domestic animals and are thus at increased risk of contracting diseases of zoonotic origin (Upper Midwest Agricultural Safety and Health Center, 2012).
Health Risks: Common Chronic Diseases
Agricultural workers are at higher risk of several chronic diseases, including respiratory diseases and chronic kidney disease of non-traditional causes (CKDnT), as well as mental health challenges (La Cooperativa Campesina de California, 2011; National Center for Farmworker Health, 2015). Asthma, bronchitis, and “farmer’s lung”—an allergy caused by the inhalation of moldy hay, straw, grain, or tobacco dust—are often associated with agricultural work. Additionally, compared to other populations, agricultural workers have been found to have higher mortality rates due to respiratory conditions (La Cooperativa Campesina de California, 2011). Chronic kidney disease can be caused by or correlated with several other chronic conditions, such as diabetes and high blood pressure (Centers for Disease Control and Prevention, 2017). CKDnT is becoming increasingly reported in young male farmworker populations in Asia and Central America (Almaguer et al., 2014; Ordunez et al., 2014). Additionally, these chronic diseases are correlated with the presence of other chronic and infectious diseases including tuberculosis (National Center for Farmworker Health, 2018).
While there is limited data on the physical health of agricultural workers, the data are even more constrained when it comes to agricultural workers’ mental health as this topic is often seen as taboo in many parts of the world. However, studies have found that in addition to potentially contracting chronic physical diseases, farmworkers are at increased risk of developing mental health disorders due to the physical demands and stress of their work as well as their frequent separation and isolation from their families because of migratory and seasonal employment (National Center for Farmworker Health, 2015). A recent study by the Farmworker Advocacy Network in the United States reported that out of the farmworkers surveyed, 40% reported experiencing depression and 30% reported experiencing anxiety (La Cooperativa Campesina de California, 2011). Other studies have reported that 25% of farmworkers have experienced at least one mental health disorder at some point in their lives. Such disorders include heightened stress, depression, and anxiety (Winkelman et al., 2013).
Case Study: Health and Safety in Nigeria
Livestock and poultry facilities are important considerations for human and animal health and welfare concerns. An example of how livestock are kept and managed in Nigeria from Nigeria-native Osemwegie Odia, Ph.D., DVM, DABT, is included below. Dr. Odia was educated at Texas Tech University (Ph.D.) and the University of Ibadan (DVM) and is currently a product safety toxicologist at Lòreal in Clark, NJ.
In Nigeria, there is a diversity of livestock and it is largely dependent on location. There is also a large market for hunted animals from the forest.
In the southern portion of the country, livestock operations are more organized with concentrated feeding operations, particularly poultry farming and piggeries. These are primarily privatized and are comparable to intensive livestock operations in westernized nations, such as the United States. Several levels of veterinary services are provided, from veterinary technologist provision of basic services to more sophisticated engagement with veterinarians and veterinary consultancy services in the instance of larger farm operations.
In many rural areas, there are small livestock and poultry operations. For example, a small rural family can have four goats and six hens, all with identifiable markings. These animals typically are not fed and have forage for their food, but return to the family for shelter at night. It is a simple operation for the family as there are no additional costs for feeding or provision of veterinary services. This is an important source for protein for a family that cannot afford to buy livestock produce. Although this method is not very productive (in many instances the animals are starved) it is still an on-going practice in many parts of Nigeria.
In the northern region of the country, cattle, sheep, and goats are the predominant livestock. These differences could be attributed to climatic conditions, with a longer dry period in the north compared to the southern part of the country. This also translates to less severe parasitic infestation and reduced capacity for mortality. Cattle are in the exclusive preserve of the Fulani herders and graze freely across west and central Africa. It is not just a business venture for the herders but is better understood as a symbiotic relationship. The average Fulani man prides himself on a large herd. They also pass a few cattle to their sons to start their own nomadic herd. They harvest milk and cheese from the cattle and sometimes bleed the cattle for nutrition. In turn, they provide companionship, protection, and care for the cattle. There is no selective breeding or culling from the herd. The average cow takes 5-10 years to get to considerable slaughter weight.
The average Fulani man is very resourceful and does not seek solely wealth from their cattle. They hunt and pick wild fruits from the jungle and they build huts from materials sourced in the forest. They only sell the cattle when in dire need of financial support, or the animal is sick, not viable, or about to die from old age. In recent times, there have been many violent exchanges between the Fulani herdsmen and nearby farmers because development and climate change has decreased viable options for the cattle to forage. The other livestock system in the northern region is a similar system of livestock rearing to the rural southern part of the country with few animals attached to one family.
In terms of veterinary regulation, drugs are controlled by the government regulatory body. In theory, veterinary medication and antibiotics are only sold when prescribed by veterinarians. This is also the practice with vaccines. However, apart from the well-established livestock operations, these services are seldom used. The government also tries to provide free veterinary services to rural community members, but this does not frequently occur.
Considering the large population in developing countries, there is great potential for a booming livestock industry in these countries, but as with many other problems in developing countries, there are constraints to this becoming a success.
Conclusion
Farmworkers are at increased risk of injuries, chemical exposure, and acute and chronic diseases due to the material conditions of their occupation as well as their oftentimes limited or nonexistent access to clean water and adequate shelter. Combined with the harsh realities of many farmworkers’ limited access to quality healthcare, these challenges lead farmwork to be consistently ranked among the most dangerous occupations, with farmworkers at a doubled risk of job-related fatalities compared to those employed in other occupations (International Labour Organization, 2015). Unfortunately, data are limited on health status, outcomes, and care available to this population and risks may be even higher than reported. Future studies focusing on this occupation and population could aid in improving health outcomes and reducing health inequalities for farmworkers, their families, and communities.
Further Exploration
Check out the following organizations!
Farmworker health
National Center for Farmworker Health
North Carolina Farmworker Health Program
Occupational health and safety
International Labor Organization
Agricultural worker safety
Pesticide exposure, illnesses, and injuries
Vector-borne diseases
Zoonotic diseases and disease risk
Upper Midwest Agricultural Safety and Health (UMASH) at the Minnesota Department of Health
Want to get involved?
Learn how you can get involved and improve farmworker access to safe living and working conditions and quality healthcare. The Farmworker Justice program has resources to help you!
There are also opportunities to immerse yourself in these issues at Penn State.
Learn more about farmworker health and safety through Penn State Extension resources:
- Farm Safety
- Food Safety and Quality
- Farm Worker Health and Hygiene Basic Rules
- Farm Worker Health and Hygiene Video
- Worker Protection Standard and Agricultural Safety and Health
Check Your Knowledge
What are the four main routes by which farmworkers may be exposed to hazards due to their occupation?
Answer: Job-related injuries, agrochemical exposure, extreme working and living conditions, and disease (including infectious, communicable, vector-borne, and zoonotic diseases) can all can lead to chronic illnesses.
Pesticide exposure can cause a rash but no long-term consequences. True or false?
Answer: False. Pesticide exposure can result in acute symptoms including a rash but also nausea, vomiting, and itchy and burning eyes. It can also cause chronic illness and may lead to cancer, neurological disorders, reproductive disorders and challenges, and mental health issues including depression.
What are two of the most common causes of occupational injury for farmworkers?
Answer: On-the-job injuries such as sprains, back pain, and knee pain are common among farmworkers. Common causes of acute illness or even death are often attributed to heat-related illness. Infectious and parasitic diseases are also commonly reported among farmworkers.
Synthesis Questions
What would you include as part of a general training for farmworkers who work with crops and livestock and use agrochemicals as part of their job?
A small-scale cattle farmer in Kenya is seeing an increase in ticks attached to her cattle. She also has a dog that sleeps outside but goes in and out of her home, where she, her husband, and three young children live. None of the animals are acting differently than they were the week before when she noticed fewer ticks. Since it does not seem to be outwardly affecting the cattle, should she do anything about the increased tick burden she has noticed? Briefly explain your reasoning given the potential risks mentioned in the chapter.
What options are available to mitigate many of the risks and hazards associated with farmworker labor described in this chapter?
References
Almaguer, M., Herrera, R., & Orantes, C. M. (2014). Chronic kidney disease of unknown etiology in agricultural communities. MEDICC Review, 16(2), 9–15.
Byrne, A. L., Marais, B. J., Mitnick, C. D., Lecca, L., & Marks, G. B. (2015). Tuberculosis and chronic respiratory disease: A systematic review. International Journal of Infectious Diseases, 32, 138–146. https://doi.org/10.1016/j.ijid.2014.12.016
Centers for Disease Control and Prevention. (2020, October). Agricultural safety. National Institute for Occupational Safety and Health. https://www.cdc.gov/niosh/topics/aginjury/default.html
Centers for Disease Control and Prevention. (1992). Prevention and control of tuberculosis in migrant farm workers. Mortality and Morbidity Weekly Review. https://www.cdc.gov/mmwr/preview/mmwrhtml/00032773.htm
Centers for Disease Control and Prevention. (2017). National chronic kidney disease fact sheet. U.S. Department of Health and Human Services.
Gubernot, D. M., Anderson, G. B., & Hunting, K. L. (2015). Characterizing occupational heat-related mortality in the United States, 2000–2010: An analysis using the census of fatal occupational injuries database. American Journal of Industrial Medicine, 58, 203–211. https://doi.org/10.1002/ajim.22381
International Labour Organization. (2015, March). Agriculture: a hazardous work. https://www.ilo.org/safework/areasofwork/hazardous-work/WCMS_110188/lang–en/index.htm
La Cooperativa Campesina de California. (2011, September 21). Health issues for migrant workers. Voice of the Fields: California. Farm Labor Information Bulletin.
National Center for Farmworker Health. (2015). The health of male agricultural workers.
National Center for Farmworker Health. (2018). Tuberculosis & U.S. agricultural workers.
North Carolina Farmworker Institute. (2008). North Carolina farmworker health facts.
Ordunez, P., Saenz, C., Martinez, R., Chapman, E., Reveiz, L., & Becerra, F. (2014). The epidemic of chronic kidney disease in Central America. The Lancet: Global Health, 2, e440-e441. https://doi.org/10.1016/S2214-109X(14)70217-7
Upper Midwest Agricultural Safety and Health Center. (2012). Common zoonotic diseases from farm animals. Acute Disease Investigation and Control. Minnesota Department of Health.
Winkelman, S. B., Chaney, E. H., & Bethel, J. W. (2013). Stress, depression and coping among Latino migrant and seasonal farmworkers. International Journal of Environmental Research and Public Health, 10(5), 1815–1830. https://doi.org/10.3390/ijerph10051815
World Health Organization. (2020). Vector-borne diseases. World Health Organization.
Żukiewicz-Sobczak, W. A., Chmielewska-Badora, J., Wróblewska, P., & Zwoliński, J. (2013). Farmers’ occupational diseases of allergenic and zoonotic origin. Advances in Dermatology and Allergology, 30(5), 311–315.
