The California Agricultural Worker Health Survey

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The California Agricultural Worker Health Survey

• Conducted by the California Institute for Rural
  Studies
• Funded by The California Endowment

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Investigators and Key Staff

• David Lighthall, Executive Director
• Don Villarejo, Founder Director Emeritus
• Bonnie Bade, Co-investigator
• Steve McCurdy, Co-investigator
• Richard Mines, Co-investigator
• Steve Samuels, Project Statistician
• Daniel William III, Project Coordinator
• Ann Souter, Senior Site Coordinator

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Random Selection of Subjects

• Communities Five of six agricultural regions
  represented by randomly selected community sites.
• Dwellings Enumeration of ALL places (dwellings)
  in each community where farmworkers are found to
  reside then randomly select dwellings to
  contact.
• Residents Enumeration of ALL eligible persons
  in randomly selected dwellings then random
  selection of one or more residents to be subjects.

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Qualifications of Subjects

• Age 18 years or older
• Performed hired farm work in the previous twelve
  months
• No limit on duration of farm employment
• Livestock crop work of any type
• Exclude off-farm food processing

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CAWHS Survey Components

• Main Survey Instrument, In Dwelling, 1 ½ to 2
  hours, Interviewer
• Physical Examination, At Clinic, 20 to 30
  minutes, Medical Staff, By Appointment,
  Transportation Provided
• Risk Behavior Instrument, At Clinic, 20 to 30
  minutes, Interviewer, Private Room

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CAWHS Main Instrument

• Household Composition
• Personal Demographics
• Health Services Utilization
• Self-reported Health Conditions
• Doctor-reported Health Conditions
• Work History
• Income and Living Conditions

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CAWHS Main Instrument (continued)

• Workplace Health Conditions
• Protective Equipment Safety Training
• Working With Pesticides in the U.S.A.
• Field Sanitation
• Work Related Injuries and Injury Module
• Immigration Status

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CAWHS Physical Examination

• Biometric
• Dental
• Skin
• Body
• Screening
• Blood Chemistry
• Medical History

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Risk Behavior

• Health Habits (alcohol, tobacco)
• Domestic Violence
• Workplace Violence Workplace Risks
• Sexual Behaviors
• Drug Use
• Mental Psychological Illness
• Reproductive Health (female only)

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Summary Results, CAWHS, 1999
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CAWHS Sample, 1999, N968
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Does Your Employer Provide These EVERYDAY? N968
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Conclusions Occupational Safety and Health

• 1. High level of non-compliance with Worker
  Protection Standard pesticide training
  regulations.
• 2. For workers who are trained, the quality of
  WPS training is questionable Multiple sources
  of training with a high proportion of workers
  receiving inadequate training.
• 3. Evidence that lateral, airborne pesticide
  drift is common, suggesting weak compliance with
  WPS pesticide application rules.
• Overall, WPS appears relatively ineffective.
• High rates of musculoskeletal complaints 66
  reported chronic M-S pain in past year.
• Clear evidence of need for better eye protection
  22 report chronic eye irritation.

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Conclusions Access to Care and Chronic Disease

• Strikingly high proportions of workers who have
  rarely or never been to doctor, dentist, or
  optom.
• Major problems of access to preventative and
  primary care Dental, musculoskeletal (back,
  etc.), vision are perhaps the most serious.
• Little affordable employer-provided health
  insurance, low levels of MediCal participation.
• Cultural traditions of health care are being
  confronted by emergence of new chronic diseases
  tied to dietary changes in Mexico and the U.S.
• Genetic predisposition (diabetes) and high rates
  of obesity increase long-term risk to heart
  disease, hypertension, stroke, and diabetes.
• Looming long-term health costs for county and
  state health system if access to preventative and
  primary care is not dramatically improved.