By Elaine Bartlett, Episcopal Farm Worker Ministry
The dangers of agricultural work have been widely reported—machinery accidents and heat stroke alone cause hundreds of farmworker deaths each year. According to the U.S. Department of Labor, the fatality rate for agricultural workers is seven times higher than for all workers in private industry. OSHA recently launched a campaign to prevent heat illness among outdoor workers, and the National Institute for Occupational Safety and Health has announced it is making a “major research and outreach priority” of retrofitting older tractors – the cause of most rollover deaths – with protective structures.
However, little has been done to ensure that farmworkers are educated about and provided the means to prevent or treat another major occupational hazard of agricultural work. Skin diseases and disorders are widely prevalent among U.S. farmworkers, with an incident rate of four to six times higher than workers in all other industries. Excessive exposure to sun, as well as to pesticides, dust and fungi, combined with lack of medical treatment, contribute to a widespread problem that has a major impact on farmworkers’ quality of life. Recent research of North Carolina agricultural workers, published in the Journal of Rural Health, showed that over 95 percent of farmworkers studied were afflicted by some form of skin disease. Fungal infections and sunburn regularly affected 58 percent of North Carolina farmworkers in a 2008 study that appeared in the International Journal of Dermatology. Acne, calluses, dermatitis and tinea pedis afflicted between 40 and 67 percent of the farmworkers.
Although such problems are readily acknowledged within farmworker communities, several factors prevent effective prevention and treatment, including lack of health insurance and money for treatment. U.S. health care reform, which will be fully implemented in 2014, is not likely to have a significant impact on farmworkers’ lives. At least half of farmworkers nationwide do not have the necessary immigration status to qualify for Medicaid expansion and health insurance exchanges available to low income Americans.
Under health care reform, migrant health clinics will receive funding that will allow for an increased level of services. However, only about 20 percent of farmworkers nationwide currently utilize such clinics, according to a 2005 report by the Kaiser Commission on Medicaid and the Uninsured, and the issues that limit farmworkers’ use of such clinics are ones that cannot be addressed by the Affordable Care Act. About 90 percent of farmworkers report that they speak and read little to no English, according to the Kaiser report. The vast majority of farmworkers are Latinos from Mexico and other central American countries. While the primary language is Spanish, the Journal of Rural Health study found that 10 to 15 percent of their participants primarily spoke an indigenous language, such as Mixteco or Zapoteco, that made even Spanish language health care inaccessible.
Lack of transportation to clinics and fear of missing work – and wages – can be other factors that serve as a barrier to health care.
For these reasons, it is imperative to focus on outreach services to farmworkers in our communities to cover the gaps that government funded health care cannot address.
Providing farmworkers with access to a sufficient amount of clothing and hygienic items is key in decreasing the rate of skin disorders and other illnesses related to dermal exposure, such as green tobacco illness. Long sleeve shirts, long pants and gloves provide necessary protection from sun, chemicals, and insects, as well as nicotine residue in tobacco plants. For optimal health workers must have access to several changes of clothes per day as the fabric frequently becomes saturated with pesticides, perspiration, dust and other elements. Given that up to 30 workers may share a wash tub at camp, it is not always feasible to launder regularly, increasing the need for a significant supply of clothes per worker.
Equally important is the availability of soap, shampoo and other toiletries that cleanse the skin of pesticides - and, in the case of tobacco workers, crop residues. Providing workers with full spectrum sunblock can help reduce the incidence of sunburn and, ultimately, skin cancer. Access to hydrocortisone cream and other topical treatments significantly reduces the level of discomfort associated with dermatitis, and hydrogen peroxide and bandages can prevent infection from abrasions common to agricultural work.
Farmworkers serve a vital function in our country, harvesting crops for a wage that few Americans would consider acceptable. Farmworkers often spend the majority of each year far away from their homes and families, doing backbreaking labor and living in isolated camps in often substandard conditions. In these last weeks of summer, let us consider the harvest that we have enjoyed this season and what we can do to improve the quality of life for those who have provided for us.
Elaine Bartlett serves on the board of directors of Episcopal Farmworker Ministry. EFwM, in partnership with faith communities of all denominations in North Carolina, provides work clothing, toiletries and over-the-counter skin treatments to workers in 50 migrant labor camps in Sampson, Harnett and Johnson counties. To learn more, visit www.efwm.org