Occupational Injury and Illness in Farmworkers in the Eastern United States

  • John J. May


Farmworkers experience high rates of occupational injury and illness in an industry with fatality rates seven times higher than the national average. This chapter addresses key occupational health challenges encountered by farmworkers in the eastern United States. Some are common problems likely to be encountered by those working any commodity, while others are unique to the particular mix of crops produced in this region. This chapter reviews common occupational health problems of farmworkers, including heat stress, musculoskeletal injuries, skin disease, hearing loss, eye injury, and transportation-related injuries. Because some knowledge of geographic, commodity-specific, and other patterns of illness and injury occurrence can be of considerable assistance to the clinician, examples of prominent occupational challenges associated with selected commodities are also presented. These include orchard work, tobacco production, dairy farming, and vegetable and berry production. Recommendations for more effective protections for farmworkers and for further research are presented.


Hearing Loss Occupational Health Contact Dermatitis Musculoskeletal Disorder Occupational Injury 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Abraham NF, Feldman SR, Vallejos QM et al. (2007) Contact dermatitis in tobacco farmworkers. Contact Dermat 57:40–43CrossRefGoogle Scholar
  2. American College of Occupational and Environmental Medicine Board of Directors (1993) ACOEM Code of Ethical Conduct. Cited 26 May 2008
  3. Arcury TA, Quandt SA (2007) Health and social impacts of tobacco production. J Agromed 11:71–81CrossRefGoogle Scholar
  4. Arcury TA, Quandt SA, Preisser JS et al. (2001) The incidence of green tobacco sickness among Latino farmworkers. J Occup Environ Med 43(7):601–609PubMedCrossRefGoogle Scholar
  5. Arcury TA, Quandt SA, Garcia DI et al. (2002) A clinic based, case–control comparison of green tobacco sickness among minority farmworkers: clues for prevention. South Med J 95(9):1008–1011PubMedGoogle Scholar
  6. Arcury TA, Quandt SA, Mellen BG (2003a) An exploratory analysis of occupational skin disease among Latino migrant and seasonal farmworkers in North Carolina. J Agric Saf Health 9(3):221–232Google Scholar
  7. Arcury TA, Quandt SA, Preisser JS et al.(2003b) High levels of transdermal nicotine exposure produce green tobacco sickness in Latino farmworkers. Nicotine Tob Res 5(3):315–321CrossRefGoogle Scholar
  8. Arcury TA, Vallejos QM, Schulz MR et al. (2008) Green tobacco sickness and skin integrity among migrant Latino farmworkers. Am J Indust Med 51:195–203CrossRefGoogle Scholar
  9. Azaroff LS, Levenstein C, Wegman DH (2002) Occupational injury and illness surveillance: conceptual filters explain underreporting. Am J Public Health 92:1421–1429PubMedCrossRefGoogle Scholar
  10. Baron S, Estill CF, Steege A et al. (eds) (2001) Simple Solutions: ergonomics for Farmworkers. National Institute for Occupational Safety and Health, Washington, DCGoogle Scholar
  11. Borjan M, Constantino P, Robson MG (2008) New Jersey migrant and seasonal farm workers: enumeration and access to healthcare study. New Solut 18(1):77–86PubMedGoogle Scholar
  12. Bouchama A, Knochel JP (2002) Heat Stroke. N Engl J Med 346(25):1978–1988PubMedCrossRefGoogle Scholar
  13. Boyes WK, Tandon P, Barone S, Jr et al. (1994) Effects of organophosphates on the visual system of rats. J Appl Toxicol 14:135–143PubMedCrossRefGoogle Scholar
  14. Boyle D, Gerberich SG, Gibson RW et al. (1997) Injury from diary cattle activities. Epidemiology 8(1):37–41PubMedCrossRefGoogle Scholar
  15. Bureau of Labor Statistics (2007a) Fatal occupational injuries, employment, and rates of fatal occupational injuries by selected worker characteristics, occupations, and industries, 2006. Cited 30 Mar 2006
  16. Bureau of Labor Statistics (2007b) Illness rates by type of illness – detailed industry, 2006. Cited 30 Mar 2008
  17. Bureau of Labor Statistics (2007c) OSHA work-related injuries and illness involving days away from work, 2006. Table R1: Number of nonfatal occupational injuries and illnesses involving days away from work. Cited 27 Mar 2008
  18. Capehart T (2006) US tobacco sector regroups. Amber Waves, United States Department of Agriculture, Economic Research Service. Cited 13 Mar 2008
  19. Chapman LJ, Newenhouse AC, Meyer RH et al. (2004) Evaluation of an intervention to reduce musculoskeletal hazards among fresh market vegetable growers. Appl Ergon 35(1):57–66PubMedCrossRefGoogle Scholar
  20. Colt J, Stallones L, Cameron LL et al. (2001) Proportionate mortality among US migrant and seasonal farmworkers in twenty-four states. Am J Indust Med 40:604–611CrossRefGoogle Scholar
  21. Dementi B (1994) Ocular effects of organophosphates: a historical perspective of Saku disease. J Appl Toxicol 14:119–129PubMedCrossRefGoogle Scholar
  22. Dennis JW, May JJ (1995) Occupational noise exposure in dairy farming. In: McDuffie HH et al. (eds) Agricultural Health and Safety: Workplace, Environment, Sustainability. Lewis, Boca RatonGoogle Scholar
  23. Earle-Richardson G, May JJ, Ivory JF (1998) Planning study of migrant and seasonal farmworkers in New York State: understanding the occupational safety environment using focus groups. J Agric Saf Health, Special Issue (1):111–119Google Scholar
  24. Earle-Richardson G, Jenkins PL, Slingerland DT et al. (2003) Occupational injury and illness among migrant and seasonal farmworkers in New York State and Pennsylvania, 1997–1999: pilot study of a new surveillance method. Am J Indust Med 44:37–45CrossRefGoogle Scholar
  25. Earle-Richardson G, Fulmer S, Jenkins P et al. (2004) Ergonomic analysis of New York apple harvest work using a Posture-Activities-Tools-Handling (PATH) work sampling approach. J Agric Saf Health 10:163–176PubMedGoogle Scholar
  26. Earle-Richardson G, Jenkins PL, Stack S et al. (2005a) Estimating farmworker population size in New York State using a minimum labor demand method. J Agric Saf Health 11(3):335–345Google Scholar
  27. Earle-Richardson G, Jenkins P, Fulmer S et al. (2005b) An ergonomic intervention to reduce back strain among apple harvest workers in New York State. Appl Ergon 36:327–334CrossRefGoogle Scholar
  28. Earle-Richardson GB, Brower MA, Jones AM et al. (2008) Estimating the occupational morbidity for migrant and seasonal farmworkers in New York State: a comparison of two methods. Ann Epidemiol 18(1):1–7PubMedCrossRefGoogle Scholar
  29. Early J, Davis SW, Quandt SA et al. (2006) Housing characteristics of farmworker families in North Carolina. J Immigr Minor Health 8(2):173–184PubMedCrossRefGoogle Scholar
  30. Estill CF, Tanaka S (1998) Ergonomic considerations of manually harvesting Maine wild blueberries. J Agric Saf Health 4(1):43–57Google Scholar
  31. Faucett J, Meyers J, Miles J et al. (2007) Rest break interventions in stoop labor tasks. Appl Ergon 38(2):219–226PubMedCrossRefGoogle Scholar
  32. Flores G (2000) Culture and the patient–physician relationship: achieving cultural competency in health care. J Pediatr 136:14–23PubMedCrossRefGoogle Scholar
  33. Forst L, Lacey S, Chen HY et al. (2004) Effectiveness of community health workers for promoting use of safety eyewear by Latino farm workers. Am J Indust Med 46:607–613CrossRefGoogle Scholar
  34. Forst L, Noth IM, Lacey S et al. (2006) Barriers and benefits of protective eyewear use by Latino farm workers. J Agromed 11:11–17CrossRefGoogle Scholar
  35. Gehlbach S, Williams W, Perry L et al. (1975) Nicotine absorption by workers harvesting green tobacco. Lancet 305:478–480CrossRefGoogle Scholar
  36. Gomez MI, Hwang SA, Sobotova L, (2001) A comparison of self-reported hearing loss and audiometry in a cohort of New York farmers. J Speech Lang Hear Res 44:1201–1208PubMedCrossRefGoogle Scholar
  37. Harris PM (2006) Nonfatal occupational injuries involving the eyes, 2004. Cited 22 Mar 2008
  38. Hawkes L, May J, Earle-Richardson G et al. (2007) Identifying the occupational health needs of migrant workers. J Comm Pract 15(3):57–76CrossRefGoogle Scholar
  39. Health Resources Services Administration (1990) An Atlas of State Profiles which Estimates the Number of Migrant and Seasonal Workers and Members of Their Families. Health Resources Services Administration, Washington, DCGoogle Scholar
  40. Health Resources Services Administration (2007) Uniform data system. Table 6: Selected diagnoses and services rendered. Cited 10 Apr 2008
  41. Institute of Medicine (1988) Role of the Primary Care Physician in Occupational and Environmental Medicine (IOM Publication No 88–05). National Academy Press, Washington, DCGoogle Scholar
  42. Institute of Medicine (1993) Environmental Medicine in the Medical School Curriculum. National Academy Press, Washington, DCGoogle Scholar
  43. Janowitz I, Meyers JM, Tejeda DG et al. (1998) Reducing risk factors for the development of work-related musculoskeletal problems in nursery work. Appl Occup Environ Hyg 13(1):9–14Google Scholar
  44. Jenkins P, Stack S, Earle-Richardson G, May J (2009) Growth of the Spanish-speaking workforce in the northeast dairy industry. J Agromed 14(1) (accepted)Google Scholar
  45. Kirrane EF, Hoppin JA, Kamel F (2005) Retinal degeneration and other eye disorders in wives of farmer pesticide applicators enrolled in the agricultural health study. Am J Epidemiol 161:1020–1029PubMedCrossRefGoogle Scholar
  46. Krejci-Manwaring J, Schulz MR, Feldman SR et al. (2006) Skin disease among Latino farm workers in North Carolina. J Agric Saf Health 12(2):155–163PubMedGoogle Scholar
  47. Lacey S, Forst L, Petrea R et al. (2007) Eye injury in migrant farmworkers and suggested hazard controls. J Agric Saf Health 13(3):259–274PubMedGoogle Scholar
  48. Larsen AC, Plascencia L (1993) Migrant enumeration project. Migrant Legal Services, Office of Migrant Health, Bureau of Primary Health Care, Health Resources and Services Administration, Washington, DCGoogle Scholar
  49. Larson AC (2000) Migrant and seasonal farmworkers enumeration profiles study. Migrant Health Program, Bureau of Primary Health Care, Health Resources and Services Administration. Cited 30 Mar 2008
  50. Latko WA, Armstrong TJ, Franzblau A et al. (1999) Cross-sectional study of the relationship between repetitive work and the prevalence of upper limb musculoskeletal disorders. Am J Ind Med 36:248–259PubMedCrossRefGoogle Scholar
  51. Liebman A, Harper S (2001) Environmental health perceptions among clinicians and administrators caring for migrants. MCN Streamline 7(2):1–4Google Scholar
  52. Luginbuhl RC, Jones VC, Langley RL (2003) Farmers’ perceptions and concerns: the risks of driving farm vehicles on rural roadways in North Carolina. J Agric Saf Health 9(4):327–348PubMedGoogle Scholar
  53. Luginbuhl RC, Jackson LL, Castillo DN et al. (2008) Heat-related deaths among crop workers – United States, 1992–2006. MMWR 57(24):649–653Google Scholar
  54. Luque JS, Monaghan P, Contreras RB et al. (2007) Implementation evaluation of a culturally competent eye injury prevention program for citrus workers in a Florida migrant community. Prog Community Health Partnerships 1(4):359–369CrossRefGoogle Scholar
  55. Marvel ME, Pratt DS, Marvel LH et al. (1991) Occupational hearing loss in New York dairy farmers. Am J Indust Med 20(4):517–531CrossRefGoogle Scholar
  56. May J, Hawkes L, Jones A et al. (2008) Evaluation of a community-based effort to reduce blueberry harvesting injury. Am J Indust Med 51(4):307–315CrossRefGoogle Scholar
  57. Millard PS, Shannon SC, Carvette B et al. (1996) Maine students’ musculoskeletal injuries attributed to harvesting blueberries. Am J Public Health 86(12):1821–1822PubMedCrossRefGoogle Scholar
  58. MMWR (2004) Work-related roadway crashes – United States, 1992–2002. Morbidity and Mortality Weekly Report 53(12):260–264Google Scholar
  59. Mobed K, Gold EB, Schenker MB (1992) Occupational health problems among migrant and seasonal farm workers. West J Med 157(3):367–373PubMedGoogle Scholar
  60. Morse T, Dillon C, Kenta-Bibi E et al. (2005) Trends in work-related musculoskeletal disorder reports by year, type and industrial sector: a capture–recapture analysis. Am J Ind Med 48(1):40–49PubMedCrossRefGoogle Scholar
  61. Murphy D-J, Yoder AM (1998) Census of fatal occupational injury in the agriculture, forestry and fishing industry. J Agric Saf Health 1:55–66Google Scholar
  62. National Environmental Education and Training Foundation (2003) National pesticide practice skills guidelines for medical and nursing practice. National Environmental Education and Training Foundation, Washington, DCGoogle Scholar
  63. National Institute for Occupational Safety and Health (2003) Work-related roadway crashes – Challenges and opportunities for prevention, NIOSH Publication No. 2003–119. National Institute for Occupational Safety and Health, Cincinnati, OHGoogle Scholar
  64. National Institute for Occupational Safety and Health (2004) Worker Health Chartbook. National Institute for Occupational Safety and Health, Cincinnati, OH. NIOSH Publication No. 2004–146Google Scholar
  65. Pratt DS, Marvel LH, Darrow D et al. (1992) The dangers of dairy farming: the injury experience of 600 workers followed for two years. Am J Indust Med 21:637–650CrossRefGoogle Scholar
  66. Quandt SA, Arcury TA, Preisser JS et al. (2001a) Environmental and behavioral predictors of salivary cotinine in Latino tobacco workers. J Occup Environ Med 43(10):844–852CrossRefGoogle Scholar
  67. Quandt SA, Elmore RC, Arcury TA et al. (2001b) Eye symptoms and use of eye protection among seasonal and migrant farmworkers. South Med J 94:603–607Google Scholar
  68. Quandt SA, Feldman SR, Vallejos QM et al. (2008) Vision problems, eye care history, and ocular protective behaviors of migrant farmworkers. Arch Environ Occup Health 63:13–16PubMedCrossRefGoogle Scholar
  69. Rabinowitz PM, Sircar KD, Tarabar S et al. (2005) Hearing loss in migrant agricultural workers. J Agromed 10(4):9–17CrossRefGoogle Scholar
  70. Reigart JR, Roberts JR (1999) Recognition and Management of Pesticide Poisonings, 5th edn. EPA No. 735-R-98–003. US Environmental Protection Agency, Washington, DC. Cited 17 Jul 2008
  71. Salazar MK, Keifer M, Negrete M et al. (2005) Occupational risk among orchard workers: a descriptive study. Fam Community Health 28(3):239–252PubMedGoogle Scholar
  72. Scharf T, Kidd P, Cole H et al. (1998) Intervention tools for farmers – safe and productive work practices in a safer work environment. J Agric Saf Health, Special Issue (1):193–203Google Scholar
  73. Schuman SH, Dobson RL (1985) An outbreak of contact dermatitis in farm workers. J Am Acad Dermatol 13:220–223PubMedCrossRefGoogle Scholar
  74. Seraj MA, Channa AB, al Harthi SS et al. (1991) Are heat stroke patients fluid depleted? Importance of monitoring central venous pressure as a simple guideline for fluid therapy. Resuscitation 21(1):33–39PubMedCrossRefGoogle Scholar
  75. Smith FPE (1940) Eye injuries in agriculture. Trans Opthalmol Soc UK 60:252–257Google Scholar
  76. Sorensen JA, May J, Purschwitz M et al. (2008) Encouraging farmers to retrofit tractors: a qualitative analysis of risk perceptions among a group of high-risk farmers in New York. J Agric Saf Health 14(1):105–117PubMedGoogle Scholar
  77. Spangler JG, Arcury TA, Quandt SA et al. (2003) Tobacco use among Mexican farmworkers working in tobacco: implications for agromedicine. J Agromed 9(1):83–91CrossRefGoogle Scholar
  78. Stack SG, Jenkins PL, Earle-Richardson G et al. (2006) Spanish-speaking dairy workers in New York, Pennsylvania and Vermont: results from a survey of farm owners. J Agromed 11(2):37–44CrossRefGoogle Scholar
  79. Steinhorst B, Dolezal JM, Jenkins N et al. (2006) Trauma in Hispanic farm workers in eastern North Carolina: 10-year experience at a level I trauma center. J Agromed 11:5–14CrossRefGoogle Scholar
  80. Stiles M, Grieshop J (1999) Impacts of culture on driver knowledge and safety device usage among Hispanic farm workers. Accid Anal Prev 31:235–241PubMedCrossRefGoogle Scholar
  81. Stock SR (1991) Workplace ergonomic factors and the development of musculoskeletal disorders of the neck and upper limbs: a meta-analysis. Am J Indust Med 19(1):87–107CrossRefGoogle Scholar
  82. Tanaka S, Estill CF, Shannon SC (1994) Blueberry rakers’ tendinitis. N Engl J Med 331(8):552PubMedCrossRefGoogle Scholar
  83. Taylor SL, Coates ML, Vallejos Q et al. (2006) Pterygium among Latino migrant farmworkers in North Carolina. Arch Environ Occup Health 61(1):27–32PubMedCrossRefGoogle Scholar
  84. Tedders SH, Schafer E, Eveland AP et al. (1998) Some physician perceptions of migrant and seasonal farm worker health in 45 rural Georgia counties. J Agromed 5(3):61–77CrossRefGoogle Scholar
  85. Trape-Cardoso M, Bracker A, Dauser D et al. (2005) Cotinine levels and green tobacco sickness among shade tobacco workers. J Agromed 10(2):27–37CrossRefGoogle Scholar
  86. United States Department of Agriculture (2007) Quick Stats. Cited 17 Jun 2008
  87. Vallejos QM, Schulz MR, Quandt SA et al. (2008) Self report of skin problems among farmworkers in North Carolina. Am J Indust Med 51:204–212CrossRefGoogle Scholar
  88. Weinstein ND (1988) The precaution adoption process. Health Psychol 7(4):355–386PubMedCrossRefGoogle Scholar
  89. Wilk VA (1988) The occupational health of migrant seasonal farmworkers in the U.S.: progress report. Farmworker Justice Fund, Washington, DCGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • John J. May
    • 1
  1. 1. University of Notre Dame and Case Western Reserve School of Medicine USA

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