1. Stakeholder Panel Migrant Farmworker Health Edward L. Zuroweste MD
International Conference on Pesticide Exposure and Health July 9, NIH—Bethesda, Maryland
Stakeholder Panel
Migrant Farmworker Health
Edward L. Zuroweste MD

2. Migrant Farmworker Health Status 2002
Poor Nutrition
Poor Sanitation
Poor Housing

7. Migrant Farmworker Health Status 2002
Poor access to health care
Poor general health status
Poverty

9. Migrant Farmworker Health Status 2002
Mobility
Dangerous working conditions
High pesticide exposure rate

10. Stoop Labor

12. Plane Spraying Pesticides
Migrant Housing

13. What We Know About Migrant Farmworkers And Pesticides
California Pesticide Illness Surveillance Program
Cancer Incidence in the United Farmworkers of America
California Cholinesterase levels of pesticide mixers/handlers
Washington pesticide dose estimates for children in an agricultural community

14. California Pesticide Illness Surveillance Program 1998-2000
4,254 reports
3,092 pesticides possibly responsible
1,338 occurred in agricultural setting
465 occurred in field workers
303 occurred in packers/applicators
58% due to exposure to residue
42% due to exposure to drift

15. Cancer Incidence in the United Farmworkers of America 1987-1997
Several types of cancer were elevated in the UFW membership in comparison to the California Hispanic population.
Incidence of leukemia, stomach, cervix, uterine cancers were all statistically significantly elevated
Incidence of brain cancer was elevated but not statistically significant.
Am.J.Industrial Med. 40: (2001)

16. Cholinesterase Testing Program for Pesticide Applicators
Of the monitored workers, 24% were removed from duty for decreased plasma cholinesterase activity levels below 60% of their baseline.
JOM vol. 35 no. 1 pg (Jan. 1993)

17. Biologically Based Pesticide Dose Estimates for Children in an Agricultural Community
“The findings indicate that children living in agricultural regions represent an important subpopulation for public health evaluation, and that their exposures fall within a range of regulatory concern.”
Environ. Health Perspectives 108: (2000)

18. Why This is the Tip of the Iceberg
Most states/health care providers do a poor job at reporting pesticide exposure
Pesticide illness/injury not a frequent health concern for farmworkers

19. Migrant Farmworker Survey Most Frequent Health Concerns
1) Tooth/gum problem ) Arthritis
2) Eye problem ) Coughing
3) Headache ) High blood pressure
4) Backache ) Digestive problem
5) Strong anger ) Bladder problem
6) Nervousness ) Skin rash
7) Irritability ) Swollen joints
8) Menstrual problems ) Allergies
9) Stomach pain ) Ear pain
10) Low spirits ) Anemia
11) Short of Breath ) Diabetes Mellitus
12) Insomnia ) Asthma
13) Chest pain ) VD

23. Why This is the Tip of the Iceberg
Migrant farmworkers present to health care providers at advanced stages of illness

26. What We Don’t Know about Migrant Farmworkers and Pesticides
Low level and combination pesticide effects: Especially in children/pregnant women
National statistics on pesticide-related illness and injury
National statistics on cholinesterase monitoring of pesticide handlers

27. What Should We Do As Healthcare Providers??
We could just “hope” that things will get better.

29. What We Need Regarding Migrant Farmworkers and Pesticides
National pesticide illness reporting
Extend the Food Quality Protection Act’s (FQPA) “reasonable certainty of no harm” standard to regulate occupational risks.
Require growers to monitor the cholinesterase levels of pesticide handlers.

30. What We Need Regarding Migrant Farmworkers and Pesticides (cont)
Extend full workers compensation coverage to farmworkers in all states.
Systematically eliminate the most harmful pesticides.
Increase research/usage of nonchemical/biopesticides.