Danger In The Fields: How Hispanic Farm Workers Are Affected by Hazardous Workplace Chemicals Due to a Lack of English Proficiency

Lillian Fooks

Salisbury University

The United States and its citizens are heavily reliant on farming as a major source of food and have been for years, as “each year more than $25 billion in hundreds of different crops and commodities are produced” (Mills, Dodge, & Yang, 2009, p. 187). Additionally, immigrant workers, specifically Hispanics, have grown to make up most of the United States farmworker population. Mills, Dodge, and Yang of the Cancer Registry of Central California in a 2019 study found that United States farmworkers are “overwhelmingly Hispanic and male (72%), or Hispanic female (21%), relatively young (median age of 31 years), [and] foreign born (84%)” (Mills, Dodge, & Yang, 2009, p. 186). Farm work is a complex job that comes with a multitude of risks, including handling dangerous equipment and hazardous workplace chemicals, such as pesticides. Pesticides are found to be “a significant source of mortality and morbidity worldwide” (Remoundou, Brennan, Hart, & Frewer, 2014, p. 1113). Nevertheless, the global use of pesticides has steadily increased since the 1990s (Foucault et al., 2021). Farm workers also spend long days outdoors, falling victim to Mother Nature’s harsh elements. Anthony (2011) stated that “constant exposure to the elements can predispose MSFW [Migrant Seasonal Farm Workers] to several potential health problems” including, but not limited to, “heat exhaustion, sunburn, and skin cancer can result from long days in the hot sun. Diseases of the eyes… Skin problems… Rashes from contact with chemicals, poison ivy, ragweed, or molds found in farming areas are reported frequently” (Anthony, 2011, p. 124). These are just some of the elements that farmworkers face every day while they are hard at work. Despite these negative aspects of farming, farm workers, mainly Hispanic, continuously strive to provide food for the country and an income for their families. Hispanic farmworkers are typically non-English proficient with little educational background (Hetrick, 2015; Das, 2011). This can impact their comprehension of workplace safety protocol surrounding pesticide use, causing serious health complications, and acting as a barrier to receiving proper healthcare. Therefore, more accommodating, and helpful resources are necessary. Through thorough analysis and the combination of many scholarly findings, it is evident that solutions need to be proposed to better support Hispanic farmworkers in the United States.

One story reported by Malea Hetrick in 2015 concerns a woman named Ramona. Ramona’s story as a farmworker effectively conveys the harsh reality of farming and she has been said to be an accurate representation of most farmworkers: wearing long sleeves and a handkerchief as an attempt to protect herself from toxic fumes that suffocate her as she works with crops that have pesticides on them. This simple solution is her only option as no other protective gear had been provided by her employer. However, the days are too long to struggle to breathe through the handkerchief and too hot to wear long sleeves as she typically works in 110-degree heat. Ramona prioritized her work over her health and discontinued her use of the little protective gear she wore. Now, Ramona is asthmatic, most likely due to pesticide exposure. Ramona’s employer, like many in this industry, does not provide health insurance, and due to her low wage that she dedicates to the bills, food, and her children, she has no money left over to put toward healthcare costs (Hetrick, 2015, pp. 138-441). Unfortunately, this is a story that many Hispanic farmworkers resonate with and understand the struggle of (Anthony, 2011). Farm work in the United States seems like a nightmare to those who are privileged to work in a field that is safe and offers proper resources communicated in the worker’s preferred language. However, for Hispanic farmworkers, there are little to no resources and support that accommodate their lack of English proficiency and little understanding of educational resources (Remoundou, Brennan, Hart, & Frewer, 2014). Since Hispanic farmworkers make up a majority of those who tend to the farms the United States relies on, the resources they are provided should accommodate them, and more care, compassion, and appreciation should be shown towards them.

Proper resources must be provided to workers because farm work has been named the most dangerous occupation in the United States (Hetrick, 2015). Hetrick (2015) found that while it is suspected that there is under-reporting of the number of injuries and deaths in the field, in 2015 it was estimated that there were 130,000 disabling injuries and 780 deaths per year because of farming. Workers also face long-term and long-developing health issues from “chemical exposure, such as cancer; serious musculoskeletal injuries, traumatic injuries including amputations, respiratory and skin problems; and infectious diseases including tuberculosis” (Hetrick, 2015, pp. 446-447). Since most farmworkers are Hispanic, these life-threatening injuries and long-term health effects that are a result of repeated exposure to the dangerous elements of farming are more common in Hispanic workers, yet they receive the least support (Hetrick, 2015). Their health issues are a direct result of their work, yet they do not receive educational resources in their preferred language on how they should better protect themselves (Das, 2001). All around, Hispanic farmworkers are commonly not provided with enough resources, which is the foundation for many problems and barriers in their life and little progress has been made in better accommodating their needs.

Through their daily work, while farmworkers are exposed to a multitude of dangerous elements, they commonly come in different forms of contact with hazardous workplace chemicals, such as pesticides. This could be through applying pesticides to crops or picking fruits and vegetables that have pesticides on them (Anthony, 2011). Through this, remnants of the pesticides remain on the worker’s hands, clothes, face, or in their eyes, they could breathe them in, and consequently cause adverse health issues. Acute and chronic health problems as well as adverse reproductive effects can arise from this type of exposure. A popular group of pesticides specifically known for causing a wide variety of health issues are organophosphate pesticides which were made to poison insects and mammals (McCauley et al., 2006). While the negative effects are known, farmworkers are still required to use dangerous pesticides and the exposure they face is not in their control (Remoundou, Brennan, Hart, & Frewer, 2014). California, the top agriculture-producing state, thus employing many farmers, used over two hundred million pounds of pesticides in just one year. Sixty million pounds of these pesticides were known to cause cancer or reproductive harm, and in recent years, this trend has remained unchanging (Das, Steege, Baron, Beckman, & Harrison, 2001). The continued use of life-threatening pesticides has been deemed irresponsible by the Director of Environmental and Occupational Health for Migrant Clinicians Network, especially when the harmful effects are obvious, and nothing has changed to better protect Hispanic workers. Oftentimes these workers are unaware that they are being exposed to pesticides (MCN Admin, 2020). This is causing many leading environmental activists to become angry at the Environmental Protection Agency, however, they only weaken pesticide standards and end up endangering farmworkers more (MCN Admin, 2021).

While the risk of developing health problems when working in this field may not be surprising to some, it is extremely damaging when these problems are severe and potentially fatal, as some farmworkers develop cancer as a direct result of their work. The severity of this is amplified when Hispanic workers are repeatedly put at risk while earning a low income that is not enough to pay for treatment or healthcare costs. Mills, Dodge, and Yang (2009) conducted a study in which they explored the various types of cancer farmworkers face due to exposure. The researchers compiled data from the United Farm Workers (UFW) regarding farmworkers’ age, gender, ethnicity, and more, as well as from the database of the California Department of Pesticide Regulation (DPR) that contains information regarding pesticide usage. They explored where application occurred as well as the date, crop, type of pesticide, number of acres treated, and pounds of active ingredient applied. Through analyzing this data, the researchers were able to conclude that migrant and seasonal farmworkers are at “increased risk for several forms of cancer in comparison to the general population. In particular, the lymphatic and hematopoietic cancers are found to occur excessively in this population, as do prostate, stomach, and cervical cancers” (Mills, Dodge, & Yang, 2009). Some forms of cancer have coined the name “agricultural cancers” (Mills, Dodge, & Yang, 2009).

In addition, Foucault et al. conducted a study that sought to pinpoint the correlation between occupational pesticide exposure, OPE, and the cancer known as acute myeloid leukemia, AML. This study supported the same conclusions as similar studies done 12 years ago and found that cancer, specifically AML in this case, can be categorized as an occupational cancer in workers who are exposed to pesticides, such as farmworkers (Foucault et al., 2021). The data demonstrates that dangerous and life-threatening pesticide exposure is an ongoing trend. Three-hundred thousand farmworkers a year are “poisoned” by pesticides used to protect the crops they encounter, most of which are Hispanic (Anthony, 2011). While pesticides protect crops and aid in high production rates, they are hurting the workers who frequently encounter chemically treated crops (Remoundou, Brennan, Hart, & Frewer, 2014). Without these farmworkers, there would be no one left to tirelessly work in the fields all day, and production would decrease. Without Hispanic farmworkers, it is arguable that the agriculture industry would not be as successful as it currently is.

Farm work does not require a high proficiency in English to be successful. Given that many farmworkers are Hispanic, their first language is Spanish (Das, 2001). An astounding number of Hispanic farmworkers are non-English proficient; less than 5% reported being able to confidently read and speak English (Hetrick, 2015). Most Hispanic farmworkers are limited to only reading and speaking in Spanish. In addition, only 15% of Hispanic farmworkers received a full 12 years of formal education, and on average, only have an educational background of 6 years (Das, 2001). Being non-English proficient, Hispanic farmworkers are unable to read and understand risk communication materials that warn them about the effects of pesticides (Das, 2001). The complex language and directions provided on pesticide warning labels are typically only provided in English. Even if a Hispanic worker who understood the basic mechanics of the English language read the safety label, it is plausible that they would be unsure of what to do with the information, as many farmworkers are not provided with any other safety materials to use to protect themselves (Remoundou, Brennan, Hart, & Frewer, 2014). This could include safety goggles, gloves, a phone to call poison control if pesticides are accidentally ingested while on the job, and more. If other safety information and training regarding the risks of pesticides is provided, it is typically not taught at a level that which Hispanic farmworkers can understand (Das, 2001). Their lack of education holds them back from being an effective learner that can apply broad safety instructions to their circumstances as a farmer. Due to this lack of understanding, Hispanic farmworkers are unknowingly at immense risk in their daily work. They are more likely to misuse pesticides or not take precautionary measures. As a result, Hispanic farmworkers suffer from many adverse health effects that come with their work.

The language and literacy barriers in understanding safety procedures are not the fault of the worker, but rather due to a lack of proper resources in the worker’s preferred language. Since there is a high composition of non-English proficient Hispanic workers in this field, resources such as safety and risk communication materials should be made to accommodate them. If these resources are only provided in English, the number of people who benefit from them declines drastically, and the number of Hispanic workers suffering increases drastically. Providing broad instructions on how to protect oneself from dangerous pesticides workers are required to use that are limited to one language which most of the target population does not speak, is useless (Das, 2001). If pesticides must be used despite their deadly effects, directions on how to protect oneself should be provided in, at the very least, English and Spanish. These directions should also be communicated at a low literacy level so Hispanic farmworkers who lack a background in formal education can confidently apply them to their area of work on the farm. While farming can look different depending on the specific job of each farmworker, every aspect should be covered in detail, such as what to do if the workers get the pesticides on their clothes, on their hands, on their faces, in their mouths, in their eyes, if they are inhaled, and more. No plausible situation should be left out.

A Human and Ecological Risk Assessment in 2014 found that protective equipment is rarely used by immigrant workers. Two-thirds of farmworkers working specifically on Oregon farms reported they received no equipment or pesticide safety training at all. This study overall concluded that “engagement in unsafe pesticide use and disposal practices is the result of lack of knowledge and misperceptions of the risks associated with pesticides among operators and workers” (Remoundou, Brennan, Hart, & Frewer, 2014, p. 1114). Actual safety training in the worker’s preferred language should be required by the employer before every employee begins working in the fields with these dangerous pesticides, so if the worker is still limited in their ability to read and apply directions on safety and warning labels, they will have had background training they can rely on to keep them safe. These trainings should be required throughout their experience as a farmworker. By requiring pesticide safety training, the misuse and improper disposal of hazardous workplace chemicals will be less likely, and workers will in turn be safer. This further demonstrates that the misuse of pesticides is not the fault of the worker, but rather a lack of knowledge due to little support and resources from their employer. It should not be expected of Hispanic farmworkers to take the little resources they have and create proper safety procedures on their own. As accommodations are made to better support Hispanic farmworkers, pesticide misuse will be less common, and their use will be less life-threatening.

            While Hispanic farmworkers are predisposed to developing detrimental health issues because of a lack of understanding, they also do not receive adequate resources to treat the health issues they combat. Hispanic Americans receive unequal access to healthcare in comparison to non-Hispanic whites largely due to a lack of English proficiency. This directly affects Hispanic farmworkers working in the United States and experiencing negative health effects due to pesticide use and exposure. One study featured in the Social Science Quarterly compared the healthcare resources readily available for Hispanics, including those who are “Puerto Rican, Cuban/Cuban American, Dominican, Mexican/Mexican American, or Central or South American” and the resources available for non-Hispanic whites, which included any individual not of those ethnicities. This study concluded that “Hispanics have lower levels of access to health services than non-Hispanic whites… having health insurance coverage is strongly associated with receiving timely and continuous care” (Oguz, 2019, p. 62). This does not help the case of farmworkers, specifically migrant farmworkers, who “by definition live a highly transient lifestyle and spend a substantial amount of their time away from their home and permanent residence. Because of this, migrant farm workers often struggle to meet the state residency requirement for Medicaid.” (Hetrick, 2015, p. 442).

Due to the transitory nature of their work, these workers cannot receive timely, continuous care and need more fitting resources to assist them, even when on the move and following the season of their work. By following their work year-round, they are at higher risk for developing pesticide-related illnesses due to continuous exposure and in turn, need healthcare to be more widely available. Unfortunately, migrant workers are constantly on the move and become ineligible for Medicaid in some states, therefore, another option regarding health insurance would be receiving insurance from their employer. However, only 5 percent of farmworkers reported that they have health coverage from their employers, who hire them to do dangerous work, and 85 percent of farm workers said no health coverage at all (Hetrick, 2015). Due to their low income of less than 7,500 dollars a year, many workers do not even attempt to seek medical help (Anthony, 2011). After dedicating their low income to their family, bills, food, and more, they have no money left to cover medical bills, especially if those bills include treatment for agricultural cancers.

Many workers also fear receiving help due to the possibility of disrupting their immigration status or the status of their family. Nonjudgmental tones should be used by healthcare workers, and they should reassure the patient as they provide them care to ease their tension and fear (Anthony, 2011). Since many are afraid, even those who are eligible do not apply for any public health benefits, including Medicaid (Hetrick, 2015). While Medicaid and other public health benefits are put in place to help people, in scenarios such as this one, they only scare people off and do not help those who genuinely need it. Arguably, it would be easier to provide struggling Hispanic farmworkers with the care they need rather than actively supporting and upholding systems that work against them.

More appreciation and care must be shown for Hispanic farmworkers for the countless hours they dedicate to working in the fields to provide food for millions of people. The hard work they do to provide for others results in damage to their health. Change in healthcare policy to better support this large group of hardworking people is a necessity. Currently, “the states can, and do, require that a newly arrived resident intend to remain and live in that state permanently or indefinitely” to receive Medicaid health benefits from the state (Hetrick, 2015). Therefore, most migrant farmworkers cannot receive these benefits due to the transitory nature of their job. Farmworkers and their family are technically residents of the state, even if it is temporary, therefore, they should receive the health benefits that the state offers to every other resident. Medicaid is a federal program, but each state can create its own guidelines in the program, and it has been proven that “states have a great deal of freedom in establishing the eligibility requirements for Medicaid” (Hetrick, 2015, p. 481). If states have the resources to help these people, there should be no reason to refrain from doing so. They receive billions of dollars in federal and state funding yet actively and continuously choose to not use that funding to help all their residents, not just those who aren’t a part of a marginalized group.

If Hispanic farmworkers did have access to continuous care, which most of them do not, other barriers lie in their way, such as language and access barriers in doctors’ offices and hospitals. Tunay Oguz 2019 found that “Hispanics have been identified as suffering disproportionately from barriers to healthcare” and 26% reported a lack of English proficiency being one of these main barriers (Oguz, 2019, p. 60). A 2019 National Health Interview Survey found that those who are not English proficient and experience language barriers are less likely to attend a doctor’s visit compared to those who are proficient in English (Oguz, 2019). Language barriers, due to the commonality of non-English proficient Hispanics, are present in most healthcare facilities, which does more harm than good as it in turn results in a lack of needed care. The prominence of these barriers causes Hispanic farmworkers to refrain from going to the doctor unless it is an emergency (Anthony, 2011). Long-term exposure to pesticides can result in a long-developing illness, which would typically not be identified as an emergency that requires immediate care and treatment, therefore a visit to the doctor is not likely and the health issues present in Hispanic farmworkers are more likely to worsen. Regardless, doctors and nurses typically use complex terms that many non-English speakers cannot understand. On top of an already overwhelming experience, it can result in the trip to the doctor not even being worth it.

Changes need to be implemented not only in healthcare policies but healthcare facilities as well. If a patient cannot speak English, or it is not their preferred language, healthcare workers should use a certified translator as a resource to provide a more beneficial and comfortable experience for the patient. It has been proven that “providing interpreters in medical settings has been used to reduce language barriers” as long as the interpreter is properly trained in the context of the situation (Oguz, 2019, p. 63). Doctors and nurses should also avoid relying on young children and family members to translate, as many do because it can be an uncomfortable experience as well. Many young family members do not want to discuss their parents’ health issues and do not understand complex medical terms to do so in the first place (Anthony, 2011). At the end of their visit, instructions should be written down and given to the patient in a way that does not require a high level of literacy to understand, and the use of clear pictures should be used to further communicate future medical needs to act as a continuous reminder, even when the patient leaves the hospital (Anthony, 2011).

When communicating health-related issues with the patient, specifically with Hispanic farmworkers, doctors should remind them of the risk they are at when dealing with workplace chemicals through contact on skin and eyes, inhaling or swallowing the chemicals, and more. Advice can be given to the patient such as recommending removing contaminated clothes after work, cleaning their exposed skin with hot soap and water, and urging them to reach out to their doctor if they are feeling sick (Anthony, 2011). These reminders show Hispanic workers that they are supported and cared for. By creating a more comforting environment and providing well-rounded care, Hispanic farmworkers, if their health insurance allows, will be more likely to go to the doctor. Since the negative effects of pesticides on farmworkers have been known for years and nothing has changed, it is plausible that their use will not be discontinued anytime soon due to the role they play in high production rates (Remoundou, Brennan, Hart, & Frewer, 2014). Therefore, proper healthcare resources are a necessity for farmworkers who are working with or around pesticides and specific safety measures should be communicated to further prevent the prolonging of pesticide-related illness.

            The conjunction of a lack of English proficiency and education as well as the use of pesticides places Hispanic farmworkers in a perpetuating cycle in which they are confined to the struggles of their work. Hispanic farmworkers lack a proper educational background, which restricts their employment options, especially while being non-English proficient. Many Hispanic people looking for employment in the United States tend to turn to farm work because farm work does not necessarily require certain language proficiency, communication skills, or educational background. However, it has been concluded that “low educational levels and poor English language skills influence how MSFW [Migrant Seasonal Farm Workers] comprehend and utilize safety education, as well as how they communicate symptoms to health care providers”, putting them at risk in their work life and personal life (Anthony, 2011, p. 123). Therefore, proper educational and healthcare resources are a necessity for these workers.

The United States of America, in many aspects, lacks proper resources for Hispanic people, including educational and healthcare resources accommodating to their needs as native Spanish speakers. Educational resources, especially regarding farm work and pesticide use, provide important safety guidelines that protect workers from developing health issues or suffering from injuries. Proper healthcare resources would in turn be important for those who develop health-related issues due to their work. Developing adverse health issues, while it can be prevented and the number of Hispanic farmworkers that are affected can decrease, is ultimately inevitable in farm work. Research has undoubtedly proven that pesticides cause adverse health effects, but they are still being used and will continue to be used as seen in recent trends. Therefore, proper healthcare resources must still be provided even if educational resources on pesticide safety are made available specifically accommodating to Hispanic farmworkers. In the worker’s current conditions “Hispanics are more likely to be uninsured and less likely to be covered by employer-based health insurance than non-Hispanic whites… due to immigration status or lack of English proficiency, Hispanics tend to work at unstable and low-wage jobs that are less likely to offer health insurance benefits.” (Oguz, 2019, p. 62). These factors prove that a lack of English proficiency greatly affects Hispanic workers. Since most of these workers do not have adequate educational experience or time outside of work, learning English would not be a fair option. It would be more logical to supply the countless Hispanic farmworkers that are suffering with well-rounded resources that give them the tools to protect themselves from pesticides and receive treatment for pesticide-related illnesses.

Spending all day, sunup to sundown, working in the fields for people who do not provide accommodating resources cannot be a reassuring feeling. When someone lives in an environment in which they do not feel valued, supported, or respected they do not feel comfortable flourishing and expanding their boundaries as a human or worker. This is exacerbated when they are battling health issues. As someone battles their physical health, it is arguable that it correlates to their mental health, and therefore their quality of life. This is an opportunity for future research. One could examine the mental health issues associated with the Hispanic farmworker population and if various mental health issues worsen as physical health issues become more prominent. Researching the effects of farming on Hispanic workers can be difficult, as many workers are often traveling and undocumented, therefore, many of them are unwilling to reveal personal information for a study. While this can be a concern regarding the reliability of a study, many Hispanic workers urge for a change in the systems that oppress them. Therefore, those who can be a part of the research are more than willing. Although farmers do move across the United States following their work, with the correct tools and preparation in the study, researchers can follow them to collect the data they need. In the 21st century with research occurring seemingly everywhere, it is important to use this to implement change for those who need it, and right now, that is the Hispanic farmworker community.

Works Cited

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Das, R., Steege, A., Baron, S., Beckman, J., & Harrison, R. (2001). Pesticide-related illness among migrant farm workers in the United States. International Journal of Occupational and Environmental Health, 7(4), 303-312. doi:10.1179/oeh.2001.7.4.303

MCN Admin (2020). Earth day: Environmental racism persists with antibiotic usage in agriculture.

MCN Admin (2021). EPA weakens pesticide standards; Endangers Health of rural communities.

Foucault, A., Vallet, N., Ravalet, N., Picou, F., Bene, M. C., Gyan, E., & Herault, O. (2021). Occupational pesticide exposure increases risk of acute myeloid leukemia: A meta-analysis of case–control studies including 3,955 cases and 9,948 controls. Scientific Reports, 11(1), 1-13. doi:10.1038/s41598-021-81604-x

Hetrick, M. (2015). Medicaid and migrant farmworkers: Why the state residency requirement presents a significant access barrier and what states should do about it. Health Matrix: Journal of Law-Medicine, 25, 437-485.

McCauley, L. A., Anger, W. K., Keifer, M., Langley, R., Robson, M. G., & Rohlman, D. (2006). Studying health outcomes in farmworker populations exposed to pesticides. Environmental Health Perspectives, 114(6), 953-960. doi:10.1289/ehp.8526

Mills, P., Dodge, J., & Yang, R. (2009). Cancer in migrant and seasonal hired farm workers. Journal of Agromedicine, 14(2), 185-191. doi:10.1080/10599240902824034

Oguz, T. (2019). Update on racial disparities in access to healthcare: An application of nonlinear decomposition techniques*. Social Science Quarterly (Wiley-Blackwell), 100(1), 60-75. doi:10.1111/ssqu.12551

Remoundou, K., Brennan, M., Hart, A., & Frewer, L. J. (2014). Pesticide risk perceptions, knowledge, and attitudes of operators, workers, and residents: A review of the literature. Human & Ecological Risk Assessment, 20(4), 1113-1138. doi:10.1080/10807039.2013.799405

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