Occupational injuries and illnesses are one of the most prevalent patient care issues for clinicians working with migrant workers. Migrant patients are a unique segment of the U.S. workforce and factors such as lack of training, poor safety precautions, over representation in dangerous industries, language barriers, piece-rate pay, undocumented worker status, and geographical and cultural isolation can put these workers at increased risk for work related injuries and illnesses. Health disparities in this population are starkly demonstrated by excess mortality and injury at work. Fatal occupational injuries among farmworkers occur at five times the rate for all workers in the U.S (USDOL, 1998).

Trapé-Cardoso and colleagues described migrant workers seeking medical care at Migrant/ Community Health Centers in Connecticut. Of the 331 workers seen during medical clinic visits, 41 percent reported a work-related injury or illness. Thirty-nine percent were musculoskeletal disorders (sprains/strains, tenosynovitis, and muscle spasm), 22 percent allergies, irritation, or rhinitis, and 22 percent dermatitis (2003). The New York Center for Agricultural Medicine and Health examined over 5,000 medical charts from 12 Migrant/Community Community Health Centers and found that approximately 20 percent of visits by migrants were for obvious occupational injuries. The rate of occupational injury was as high as 50 percent for migrant men in certain clinics. Moreover, 90 percent of farmworkers with documented occupational injuries chose not to file a claim for their work-related injuries(Sorensen, 2004; NYCAMH, 1997-1999). Twenty-four percent of California agricultural workers surveyed by the NAWS reported suffering from at least one musculoskeletal injury during the previous year (Aguirre International, 2005). In a recent study in North Carolina, it was found that 45 percent of occupational heat-related deaths were in farmworkers (Mirabelli and Richardson, 2005).

Pesticides and other chemical exposures are a significant environmental hazard for farmworkers and their families. The absence of a national system for reporting pesticide poisonings makes it difficult to estimate the number of pesticide poisoning incidents in workers nationwide and estimates differ widely (Blondell, 1997; Calvert, 2004). There are a number of studies, however, that document the existence of pesticide exposures among farmworkers and their families (Arcury et. al., 2005; Arcury and Quandt, 2003; Curl, et. al., 2003, Calvert, 2004; CDC, 1997; Coronado et al., 2004).

Pesticides are essential tools in the production of the world’s food supply, in the protection of structures, in the prevention of illness transmission and in the control of vectorborne diseases. As a group, however, pesticides contain some of the most toxic chemical products produced by modern chemistry. They are also unique among toxic environmental 7 contaminants found in our environment for, like no other chemicals except war gases, pesticides are purposefully released into our environment with the intention of doing harm to living beings. In 1990, the date of the last attempted world estimate, the World Health Organization estimated there are 3 million poisonings and 200,000 deaths from pesticide exposure per year in the world and that this reflects only a fraction of the real problem. Learn more...

Lead poisoning is a preventable disease. It causes behavioral and learning disorders in children. Migrant populations face unique dimensions of exposure that increase their risk of lead poisoning such as occupational exposures, neonatal exposures, cultural practices (folk remedies, food preparation, etc), migration and substandard housing environments. Learn more...

Heat Stress is a preventable illness brought on by prolonged overexposure to heat and the sun. Please visit our Heat Stress patient education materials for more information about this sometimes fatal condition.

Despite advances in water supply and treatment, many farmworkers remain vulnerable to contaminated water supplies. Most of the water sources used to provide water to farmworkers in the fields or in the camps are private wells. This is of particular concern in agricultural areas where rain and irrigation water can carry pesticides, fertilizers and human and animals wastes through the soil and into the underlying aquifer. Farmworkers may or may not be exposed to contaminated water via poorly maintained wells. Facilities for hand washing and properly maintained excreta disposal systems may or may be available to farmworkers. Knowing that enteric infection may be an issue for farmworkers has several implications for clinicians, outreach workers, and health educators.Learn more...