Symptoms of Heat Illness Among Latino Farm Workers in North Carolina

doi:10.1016/j.amepre.2010.07.008

American Journal of Preventive Medicine

Volume 39, Issue 5, November 2010, Pages 468-471

https://doi.org/10.1016/j.amepre.2010.07.008 Get rights and content

Background

Symptoms of occupational heat illness provide an early warning that workers are in potentially life-threatening environmental conditions.

Purpose

This analysis was designed to assess the extent to which strategies to reduce the health impact of extreme heat were associated with the prevalence of heat illness among Latino farm workers.

Methods

Between June and September 2009, a total of 300 Latino men and women participated in a cross-sectional survey about farm worker health. Participants reported whether they were employed through the H-2A temporary agricultural worker program and whether they had ever worked in conditions of extreme heat during their work in the U.S. agricultural industry. Workers who had worked in extreme heat also responded to questions about selected activities and behaviors and whether they experienced symptoms of heat illness. Data analysis was conducted in 2009 to assess associations of altering work hours and activities, drinking more water, resting in shaded areas, and going to air-conditioned places during or after work, with the prevalence of symptoms of heat illness among H-2A and non–H-2A workers.

Results

Working in extreme heat was reported by 281 respondents (94%), among whom 112 (40%) reported symptoms of heat illness. Changes in work hours and activities during hot conditions were associated with a lower prevalence of heat illness among H-2A workers but not among non–H-2A workers.

Conclusions

These findings suggest the need to improve the understanding of working conditions for farm workers and to assess strategies to reduce agricultural workers' environmental heat exposure.

Introduction

Muscle cramps, heat syncope, heat exhaustion, heat stroke, and other heat-related conditions have been reported among people working outdoors (e.g., in agriculture¹ and construction²); in hot indoor or enclosed environments (e.g., drivers² and miners3, 4); and who wear heavy equipment and whose jobs require considerable physical exertion (e.g., athletes,⁵ firefighters,² and military personnel6, 7). As of 2009, California and Washington each have occupational safety standards for agriculture that address outdoor heat exposure.8, 9 A review¹⁰ of medical examiner records in North Carolina identified a large number of heat-related fatalities among farm workers, suggesting that strategies to prevent occupational heat illness among farm workers could have an important impact on heat stroke fatality overall.

Non-immigrant foreign workers brought to the U.S. to work in temporary and seasonal agricultural labor jobs are contracted through the H-2A (type of visa) temporary agricultural worker program.¹¹ Better working conditions and more safety behaviors have been reported¹² among H-2A workers than among other workers, although differences in occupational activities and workplace safety practices have not been thoroughly investigated. Using data collected during the 2009 agricultural season, this analysis was conducted to describe the characteristics of H-2A and non–H-2A farm workers who reported working in conditions of extreme heat. This paper presents self-reported data about strategies to prevent heat illness and associations between these strategies and heat illness among farm workers.

Section snippets

Methods

Between June and September 2009, a total of 300 Latino farm workers participated in a cross-sectional study designed to assess several dimensions of farm worker health. Participants were recruited from the sites maintained as living quarters for migrant farm workers (i.e., farm worker camps) in three contiguous counties in North Carolina. Spanish-speaking study personnel approached 62 camps during the recruitment stage of the study; workers in eight declined to participate and the owners, who

Results

Table 1 shows characteristics of the 300 participants. The remaining analyses were restricted to 281 participants (94%) who reported working in extreme heat, among whom 112 (40%) reported heat-related symptoms. Heat illness was less common among H-2A workers (31% vs 56%), and the percentage of participants with specific symptoms ranged from 1% (fainting) to 22% (sudden muscle cramps) among H-2A workers and 6% to 44% among non–H-2A workers, respectively.

The majority of participants reported

Discussion

Nearly 94% of the surveyed population reported working in extreme heat. Despite not having information about in which other geographic regions the participants may have worked in the past, this high percentage is unsurprising given that the participants were farm workers interviewed in a region where hot and humid conditions are common throughout the summertime. Of these respondents, nearly all reported drinking more water or taking breaks in shaded areas while working. North Carolina currently

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Citation Excerpt :
Consistent with previous studies (Martinez-Solanas et al., 2018; Xiang et al., 2014b), the types of heat-related occupational injuries frequently reported in this study included ‘manual handling’, ‘hand injuries’ and ‘wound or lacerations’. ‘Fatigue’, ‘muscle/heat cramps’ and ‘severe dehydration’ were the commonly cited symptoms of illnesses, which is consistent with previous cross-sectional studies (Dutta et al., 2015; Hunt et al., 2013; Majumder et al., 2016; Mirabelli et al., 2010; Moda and Alshahrani, 2018; Mutic et al., 2018; Spector et al., 2015; Venugopal et al., 2015; Zander et al., 2018) assessing risk factors for heat-related illness. These results point towards the contributory role of physiological factors such as fatigue, dehydration and muscle cramps as precursors to the early stages of heat-related illness and work injuries in hot weather.
Hot workplace environments can lead to adverse health effects and contribute to a range of injuries. However, there is limited contextual understanding of heat-related injury occurrence. Gaining the perspectives of occupational health and safety professionals (HSPs) may elucidate the issue and inform targeted interventions.
A cross-sectional national online survey was conducted in Australia to characterise HSP perceptions of heat-related injuries; current preventive measures; training, policies and guidelines; and perspectives on barriers for prevention. Results were analysed descriptively and a log-Poisson regression model was used to identify risk factors associated with HSP reported injury occurrence, assessed through prevalence ratio (PR).
Of the 307 HSP survey participants, 74% acknowledged the potential for increased risk of occupational injuries in hot weather. A variety of injury types and mechanisms were reported, including manual handling injuries, hand injuries, wounds or lacerations, and loss of control of power tools.
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Perceived barriers for prevention included: lack of awareness of physical injury risks, and management concerns about productivity loss and/or deadlines.
The findings indicate a range of potentially modifiable work and organisational risk factors such as more suitable PPE and better supervision. More attention to these factors, in conjunction with traditional interventions to reduce heat effects, could enhance injury prevention and labour productivity in people working in hot environments.

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Brief reportSymptoms of Heat Illness Among Latino Farm Workers in North Carolina

Background

Purpose

Methods

Results

Conclusions

Introduction

Section snippets

Methods

Results

Discussion

J Sci Med Sport

Heat-related deaths among crop workers—U.S., 1992–2006

MMWR Morb Mortal Wkly Rep

Occupational heat illness in Washington State, 1995–2005

Am J Ind Med

Heat exhaustion in a deep underground metalliferous mine

Occup Environ Med

Heat illness in the U.S. mining industry

Am J Ind Med

Predictors of hospitalization in male Marine Corps recruits with exertional heat illness

Mil Med

Brief report
Symptoms of Heat Illness Among Latino Farm Workers in North Carolina