Giulia Earle-Richardson

Occupational injury and treatment patterns of migrant and seasonal farmworkers.

ABSTRACT Migrant and seasonal farmworkers are thought to be at increased risk for occupational injury and illness. Past surveillance efforts that employed medical chart review may not be representative of all farmworkers, since the proportion of farmworkers using migrant health centers (MHCs) and area hospital emergency rooms (ERs) was unknown. The purpose of the current study was to determine the proportion of workers using MHCs versus other sources of occupational health care, and to use these data to correct previous occupational injury and illness rate estimates. Researchers conducted a survey of migrant and seasonal farmworkers in two sites: the Finger Lakes Region of New York and the apple, broccoli, and blueberry regions of Maine. Researchers also conducted MHC and ER medical chart reviews in these regions for comparison purposes. Proportions of occupational morbidity by treatment location were calculated from the survey, and a correction factor was computed to adjust chart review morbidity estimates for Maine and New York State. Among 1103 subjects, 56 work-related injuries were reported: 30 (53.6%) were treated at a MHC, 8 (14.3%) at an ER, 9 (16.1%) at some other location (e.g., home, relative, chiropractor), and 9 (16.1%) were untreated. Mechanisms of injuries treated at MHCs versus all other sources did not differ significantly. The survey-based multiplier (1.87) was applied to previous statewide MHC chart review injury counts from Maine and New York. The corrected injury rates were 7.9 per 100 full-time equivalents (FTE) per year in Maine, and 11.7 per 100 FTE in New York. A chart-review based surveillance system, combined with a correction factor, may provide an effective method of estimating occupational illness and injury rates in this population.

Improving agricultural injury surveillance: a comparison of incidence and type of injury event among three data sources.

BACKGROUND Agriculture ranks as one of the most hazardous industries in the nation. Ongoing injury surveillance is key to identifying and preventing major sources of injury. OBJECTIVE The objective of this study was to compare the total number and types of injuries identified from community reporting versus two newly available medical data systems. These new systems are important because they are less time consuming and expensive to maintain. METHOD Farm injury case records from 2007 were collected for 10 NY counties from the following sources: ambulance reports, hospital data, and community surveillance data. RESULTS For the 107 ambulance report cases, horses (35%), tractors (15%), and livestock (10%) were the three leading injury sources. For the 261 hospital cases, the leading sources were hand tools (24%), farmstead machinery (23%), and buildings/structures/surfaces (22%). Tractor injuries (37%) were the most common source of injuries identified by the 44 community surveillance cases. Struck by object was the most frequent injury event type for hospital and surveillance data (34%, 30%). Falls were the highest category for ambulance reports (36%) and were also common for hospital data (29%). Nine of the 11 fatal cases were found through community surveillance. CONCLUSION Ambulance reports and hospital data contribute a large number of additional farm injury cases to existing surveillance data. From these cases, horse injuries, falls, and hand tool injuries appear to play a larger role in farm injuries. Future research should explore how to best use these electronic resources for agricultural injury surveillance.

The Social Marketing of Safety Behaviors: A Quasi–Randomized Controlled Trial of Tractor Retrofitting Incentives

OBJECTIVES We assessed the effect of social marketing incentives on dispositions toward retrofitting and retrofitting behavior among farmers whose tractors lacked rollover protective structures. METHODS From 2006 to 2007, we conducted a quasi-randomized controlled trial with 391 farm owners in New York and Pennsylvania surveyed before and after exposure to 1 of 3 tractor retrofitting incentive combinations. These combinations were offered in 3 trial regions; region 1 received rebates; region 2 received rebates, messages, and promotion and was considered the social marketing region; and region 3 received messages and promotion. A fourth region served as a control. RESULTS The social marketing region generated the greatest increases in readiness to retrofit, intentions to retrofit, and message recall. In addition, postintervention stage of change, intentions, attitudes, subjective norms, and perceived behavioral control levels were higher among farmers who had retrofitted tractors. CONCLUSIONS Our results showed that a social marketing approach (financial incentives, tailored messages, and promotion) had the greatest influence on message recall, readiness to retrofit tractors, and intentions to retrofit tractors and that behavioral measures were fairly good predictors of tractor retrofitting behaviors.

Ergonomic Analysis of New York Apple Harvest Work Using a Posture-Activities-Tools-Handling (PATH) Work Sampling Approach

Although back, neck, and shoulder strains are common among migrant and seasonal orchard workers, little data currently exist regarding the ergonomic factors contributing to this problem. We adapted Posture-Activities-Tools-Handling (PATH) instruments and methods for ergonomic job analysis of apple harvest work in three New York orchards, and used the resulting protocol to quantify hazardous activities, loads, and postures. Using a prototype developed previously, we trained twelve contract orchard observers with classroom training and supervised orchard practice. The PATH data were then collected on 14 orchard workers over four days (2,900 observations). Mean coefficients of variation ranged from a low of 0.212 (standing leg neutral) to a high of 0.603 (trunk moderate flexion). Most frequently observed activities were: picking (62.9%), placing and moving apples in the bag (8. 7%), and walking (8.1%). Weight bearing (>10 lb, >4.54 kg) was observed 78.5% of the time throughout a range of activities. Apple harvest work is comparable with other ergonomically high-risk occupations. Future research should focus on low-cost interventions that reduce load and awkward postures.

Growth of the Spanish-speaking workforce in the northeast dairy industry.

ABSTRACT The Spanish-speaking proportion of the Northeast dairy industry workforce is believed to be increasing. This study quantifies the extent of this increase over time in New York, Pennsylvania, and Vermont, and compares demographics between English- and Spanish-speaking workers. A total of 293 farms were followed for 21 months via telephone. The proportion of the Spanish-speaking dairy workforce was measured. Differences in demographic characteristics were assessed. The proportion of Spanish-speaking workers increased linearly for both large and small farms. The rate of increase was much greater on large farms. Linear models predicted that 53.2% of the large and 18.1% of the small farm workforce would be Spanish speaking within 5 years. Spanish-speaking workers worked significantly longer weeks than their English-speaking counterparts. The Occupational Safety and Health Administration (OSHA) monitoring cutoff for number of employees is currently 10. Consequently, the increase in the proportion of Spanish-speaking workers in dairy, who have been shown to work more hours per week, is likely to result in fewer workers per farm. This could have implications for farms currently under OSHA regulations based on having 10 or more workers, because farms with workers working longer hours per week will employ fewer workers overall. In addition, according to section 330 of the Public Health Service Act, these workers do not currently meet the migrant farmworker definition that would qualify them to receive primary health services from federally funded migrant health centers. New legislation is needed to formally qualify this growing indigent population to receive healthcare via channels that are currently available to migrant and seasonal farmworkers.

Identifying the Occupational Health Needs of Migrant Workers

Abstract The Community Collaboration for Farmworker Health and Safety is a community-based undertaking comprised of migrant farmworkers, agricultural employers, health professionals, and community stakeholders. The eventual goal of the project is the creation, evaluation, and dissemination of interventions demonstrated to reduce the risk of occupational injury. To do this, the project must build a functional, community work team, and this team must identify the occupational health problem of greatest significance to the community. In this report, the methods of these initial stages of this project are examined by assessing the measurable progress and the observations of project staff and project evaluators. These assessments document both the successful creation of an effective work team and the teams completion of its initial objectives. The assessments also note issues with irregular attendance by some team members, difficulties with some of the essential tasks designated for the team, and imbalance of power among members of the team. Approaches to dealing with similar issues in future projects are suggested.

Spanish-speaking dairy workers in New York, Pennsylvania, and Vermont: results from a survey of farm owners.

Abstract A New York Center for Agricultural Medicine and Health (NYCAMH) study surveyed 294 dairy farms in New York, Pennsylvania, and Vermont. The study utilized a quarterly telephone survey to assess the proportion of Spanish-speaking workers on these farms, and also to contrast the hazard level of work tasks and prevalence of lost work time between Spanish-and English-speaking workers. The total workforce followed in the study was comprised of 14.4 percent Spanish-speaking workers, with larger farms having a higher proportion than smaller farms (19.9% versus 4.6%, respectively). Of the 294 farms, 22.5 percent had at least one Spanish-speaking worker, which differed, greatly between larger and smaller farms (51.5% versus 7.3%). Spanish workers were significantly younger, worked significantly longer hours and had significantly fewer years of employment than their English-speaking counterparts. Work hour differences were more pronounced on the larger farms. Lost work time, due to on-farm injuries, did not differ between the Hispanic workers and the non-Hispanic workers. After correcting for both age and length of farm employment, Spanish-speaking workers were far less likely to perform managerial functions than their English-speaking counterparts (OR = 22 p < .01).

Electromyographic assessment of apple bucket intervention designed to reduce back strain.

The authors previously developed an apple bucket that was modified by use of a hip belt to reduce muscle fatigue. The intervention of belt use was accepted by workers and shown not to interfere with productivity. However, use of this intervention did not appear to reduce muscle fatigue when measured by tests of voluntary muscle strength. The purpose of the present study was to evaluate the interventions effect on muscle fatigue employing surface electromyographic (EMG) amplitude. Amplitude measurements on 15 muscles were taken from 10 laboratory volunteers who were carrying a full bucket of apples, once while wearing the intervention belt and once without the intervention. These measurements were taken for seven different postures (four angles of trunk flexion (0°, 20°, 45°, 90°) and three raised-arm positions (both up, dominant up, non-dominant up)) common to apple harvest work. Participants were measured in these conditions both with the bucket carried in front and with the bucket carried to the side. Significant reductions in amplitude favouring the intervention were seen for 11 of the 15 muscles in models considering the four body flexion angles. Ten of these were of the middle and lower back. These control/intervention differences were seen with both bucket-carrying positions (front vs. side) and tended to increase with increasing flexion angle. In contrast, no significant intervention effects were observed in models considering treatment by arm-raised position. One significant main effect (upper trapezius, side bucket) showed an amplitude reduction in the treatment condition. Another main effect showing increased amplitude in the intervention condition use was observed in the dominant levator scapulae (side bucket). Thus, the use of the intervention belt reduces EMG amplitude among a number of mid- and lower-back muscles. This is suggestive of a protective effect against back strain.

Orchard Evaluation of Ergonomically Modified Apple Bucket

Abstract Background: While preliminary laboratory tests indicate that a hip belt reduces the load on the back, neck and shoulders associated with musculoskeletal strain, an orchard trial is needed to more realistically assess both effectiveness and acceptability. Objective: to evaluate the hip belts effectiveness in three areas: worker acceptance, worker productivity, and one-day muscle fatigue of the back and shoulder. Methods: Ninety-six New York apple harvest workers were randomly assigned to use the intervention hip belt or placebo belt for one week. In a second week all workers switched conditions. Subjects were interviewed at the end of each week to ascertain intervention acceptance. Employer records were reviewed to determine bushels picked per day. Subjects also underwent muscle fatigue testing at the beginning and again at the end of one workday during each week. Results: Ninety-one percent of the subjects favored the intervention hip belt. Use of the intervention did not appreciably slow picking speed (bushels per hour) as compared to placebo (8.8 bu/ hr vs. 8.89 bu/hr). Both were significantly faster than the regular equipment condition (8.13 bu/hr). No significant differences in one-day muscle fatigue were found with intervention use. Conclusions: The belt was acceptable to the workers and did not hinder productivity. However, the anticipated ergonomic benefits were not demonstrable using one-day strength testing.

Estimating Farmworker Population Size in New York State Using a Minimum Labor Demand Method

Assessment of health needs and services for hand-harvest farmworkers requires reliable population estimates. In New York State, the only publicly available source for these is the Department of Labor (DOL). However, published production data exist that may enable estimation of minimum labor demand (MLD) for hand-harvest labor. Our objective was to develop an estimation process for minimum labor demand (MLD) for hand-harvested crops in NYS and contrast the results with DOL estimates. Four crop strata (below ground, ground, bush/vine, and orchard) were identified. MLD (measured in worker-seasons) was estimated by dividing the total annual harvest hours required for each crop stratum by the total hours worked by one worker in a season for that crop stratum. The MLD estimate of the total number of worker seasons combined for all strata (14,121) was higher than that of the DOL (8,230). Harvest acreage was unavailable for 21% of the 991 county-crop combinations studied; therefore, data were imputed from other sources. Within these strata, the greatest difference was found for ground crops, where the DOL count was 28% of the size of the MLD estimate. DOL and MLD estimates were closest in orchard crops (DOL 109% of MLD). Publicly available data provide a potentially valuable source of informationfor estimation of the MLD. Use of these methods implies that the DOL may substantially underestimate the size of this population. Differences seen between the two methods were sensitive to the crop type. County-level farm surveys to verify MLD estimation factors would enhance the methods accuracy.