1. Pesticide Protective Behaviors of Latino Migrant and Seasonal Farmworkers in NC
AnnMarie Lee Walton, PhD, MPH, RN, OCN, CHES
Postdoctoral Fellow
University of North Carolina at Chapel Hill
School of Nursing
Catherine LePrevost, PhD
Director, Community Outreach and Engagement
Center for Human Health and the Environment
North Carolina State University

2. Background Pesticides may have adverse health effects
Acute: nausea, vomiting, headache, dizziness, skin rash
Chronic: damage to nervous system, reproductive problems, cancer risk
The Agricultural WPS currently mandates pesticide protective behaviors (PPB) be taught to field workers within 5 days in the field and every 5 years
wearing long-sleeved shirt, long pants, closed shoes, socks
washing of hands and face before eating, drinking, using the bathroom, smoking, and chewing gum or tobacco
gloves have shown some efficacy but are not mandated
hand sanitizer has been shown to increase pesticide metabolites
Recent WPS changes require annual training and no grace period (1/2/2017)
Hand sanitizer Coronado more urinary metabolites w hand sanitizer than traditional washing- One plausible explanation is that hand sanitizers generally
contain alcohol, which may dry the hands, making them more
susceptible to the transfer of pesticides into the skin. Whereas water
washes away residues on the skin, hand sanitizers apply agents (usually
antibacterial) that may further attract dust and other residues.

3. Selected Study Goals
Compare and contrast observed and reported behaviors of Latino migrant and seasonal farmworkers to those mandated to be taught in EPA’s WPS.
Identify Latino migrant and seasonal farmworkers’ & growers’ perceived barriers and strategies to counter barriers to using the behaviors mandated to be taught in EPA’s WPS.

4. Study Locations Three tobacco farms in one county in North Carolina
Variation in farms (# of workers ranged from 7-59)

5. Study Design Recruited 3 growers; all from Certified Safe Farm program
Neither growers nor farmworkers knew the focus on pesticides
Collected data sequentially across the 3 farms
All farmworkers participated, N= 72*
Observed farmworkers in the field ( hrs)
Questionnaires and targeted interviews for farmworkers on following Sunday evening
Growers interviewed last
*71 in observational data

6. Participant Description

7. Observation Tool

8. Observed vs. Self-Reported Behavior (Mandated)
All of the time
Yes
Some or most of the time
Sometimes
Never No
Wilcoxon test
Clothing
Wearing closed shoes * 3 type
Observed
Reported 65 66  6  5  0
-.378 (p=.705)
Wearing socks ** 11 70  1  2
.000 (p=1.00)
Wearing long sleeves 64 69
(p=.028)
Wearing long pants 71
(p=.157)
Washing
Washing hands before eating***  7  4 34
(p=.000)
Washing face before eating 46 15 41 10
(p=.000)
Washing hands before drinking****
 62
(p=.000)
Washing face before drinking 31 18 22
(p=.058)*****
*See observed behavior table: not all shoes used were protective **There were 58 people for whom the use of socks could not be observed so the N for the variable obs_socks is 13 ***There were 30 people from whom eating was not observed so the N for the variables obs_wash_hands_before_eating and obs_wash_face_before_eating is 41 ****There were 2 people for whom drinking was not observed so the N for the Variables Obs_wash_hands_before_drinking and Obs_wash_face_before drinking is 69 *****Trend

9. Observed vs. Self-Reported Behavior (Non-Mandated)
All of the time
Yes
Some or most of the time
Sometimes
Never No
Wilcoxon test
Non-WPS mandated
Wearing gloves
Observed
Reported 28 59 29  9 14  3
(p=.000)
*See observed behavior table: not all shoes used were protective **There were 58 people for whom the use of socks could not be observed so the N for the variable obs_socks is 13 ***There were 30 people from whom eating was not observed so the N for the variables obs_wash_hands_before_eating and obs_wash_face_before_eating is 41 ****There were 2 people for whom drinking was not observed so the N for the Variables Obs_wash_hands_before_drinking and Obs_wash_face_before drinking is 69 *****Trend

10. Barriers to PPB – Farmworker Perspective
Nothing (70%)
Wetness (40%):
“The shirt starts getting wet and that’s how one starts having contact with the pesticide”
“When one starts to sweat, the pores open and the anxiety begins. If you are not careful to bathe or wash your hands before eating something, since you have your pores open, you get dizzy or vomiting because as a worker, you have your pores open because of the sweat.”
Heat (33%)
Laziness (10%)
Growers said heat and time

11. Strategies to Overcome Barriers and Use More PPB – Farmworker Perspective
Have supplies on hand
Use medications and ointments
Prepare a backpack and change
Communicate warnings
Use “suero”
Drink milk
We observed the regular use of hats, water-resistant outerwear
Growers said better equipment design, using more of what they provide

12. The Role of Experience and Training
Those with more training had more perceived susceptibility to illness and were more likely to find protective behaviors effective
Those with more experience used less protective clothing
Training video spent 1% of the time on washing behaviors

13. Other Interesting Findings
Washing supplies provided 65% of the time in this study
When provided, farmworkers used 65% of the time
Green tobacco sickness was mentioned often in interviews with farmworkers

14. Opportunities for Research
Self-report should not be used in place of actual behavior
Include non-tobacco, non-safety oriented farms
Explore efficacy of farmworker strategies such as use of hats, water- resistant outerwear, and mouth coverings to minimize exposures to pesticides

15. Opportunities for Practice
Education to reinforce the importance of washing behaviors in the field
Tailored training in tobacco should include behaviors that decrease risk for GTS and pesticide exposure
Utilization of moderately experienced workers as peer trainers
More frequent training may be beneficial
Provision of adequate supplies must be 100% of time per Field Sanitation Regulation
Farmworkers and growers can work together around safety issues

16. Questions about the study?