Eye Symptoms and Use of Eye Protection Among Seasonal and Migrant Farmworkers

South Med J. 2001;94(6) 

In This Article

Abstract and Introduction

Background. Farmworkers face an array of environmental and workplace hazards that pose risks of eye damage from accidents involving agricultural chemicals and equipment and from exposure to wind, dust, and ultraviolet rays. Eye safety risks are known among industrial and agricultural occupations, yet little is known about the prevalence of eye symptoms and use of eye protection among farmworkers.
Methods. A survey of 197 Latino farmworkers in North Carolina used self-report data to measure workers' prevalence of eye symptoms and eye protection use.
Results. Eye pain and redness after working all day in the field were reported by more than 40% of workers. Most (98.4%) reported not wearing sunglasses when working in the fields; reasons included lack of sunglasses and interference with field tasks.
Conclusions. Eye symptoms are prevalent in this population. Failure to use eye protection indicates the need for further education and training of Latino farmworkers and their employers about occupational risks to eyesight.

Workers face a variety of hazards to their eyes, including unintentional injuries; exposure to chemicals, dust, and infectious agents; and exposure to ultraviolet and other radiation. While the potential for eye injuries exists in nearly every occupation, with 1,000 workplace eye injuries occurring every day,[1] agricultural workers have eye injuries and illnesses at a rate 2.5 times that of all industries combined.[2] The Bureau of Labor Statistics reported for 1998 that eye injuries and illnesses accounted for 5.7% of lost workdays in the agricultural sector, with a rate of 16.8 injuries and illnesses per 10,000 workers.[3] The focus of most research and surveillance has been acute traumatic injuries, rather than chronic long-term exposures.[4,5,6]

Agricultural workers doing fieldwork risk traumatic eye injuries caused by plants, tools, and equipment. In addition, they experience constant exposure to agricultural chemicals, wind, dust, allergens, and ultraviolet (UV) light.[7] These farmworkers spend considerable time outdoors during daylight hours when UV rays are strongest. Short-term effects of exposure to UV-A and UV-B rays include photokeratitis, eye sensitivity, and irritation. Long-term effects include pterygia, pingueculae, cataracts, and retinal damage.

The population of agricultural workers in the United States includes an estimated 4.2 million migrant and seasonal farmworkers and their dependents, most of them Mexican.[8,9] Because of their working conditions, this group is at high risk for eye injuries and other eye conditions but has limited access to health care.[10] Virtually no research has been published documenting eye injuries, eye illnesses, or eye protection use among these workers. Existing studies in agriculture have surveyed only farm operators and the household members[4] or have relied on hospital admission reports.[5] A survey of health care providers in migrant farmworker clinics conducted for the Migrant Clinicians Network in 1996 found that refractive errors were the most common eye problems seen in migrant patients, followed by eye infections, diabetes-related eye problems, and pterygia. However, no survey of farmworkers was actually done; questions regarding eye symptoms were not included.[6]

Health care providers in North Carolina note that pterygia are seen among farmworkers. A pterygium is an abnormal fold of membrane that begins to grow over the cornea, affecting vision and causing corneal damage in some cases. Symptoms of pterygia include blurred vision, burning, tearing, a feeling of having sand in the eye, irritation, itching (dry eye syndrome), and corneal irritation.[8] Pterygia typically occur in persons who spend considerable time outdoors for occupational or recreational activities and in people living closest to the equator.[11,12,13,14] Welders have also been shown to have significantly high rates of pterygia due to their exposure to UV-C radiation.[15] Ultraviolet light exposure is believed to be the most significant risk factor in the development of pterygia,[13,16,17,18] though allergens, chemicals and other irritants (eg, wind, dirt, dust, smoke, air pollution), and heredity[19] may contribute to the formation of pterygia.

The effects of UV radiation are cumulative, and research has shown that even low amounts of sunlight can increase the risk of having eye disorders.[20] The best method of protection against UV rays, dust, wind, and other allergens that cause pterygia and other disorders is the use of a wide-brimmed hat and sunglasses.[17] Despite the risk of eye disorders, anecdotal reports and observations indicate that most farmworkers do not wear sunglasses when working outdoors. The reasons for this lack of use are not clearly understood or documented. Although potential occupational and recreational exposures to UV have been examined among workers in several industries (eg, outdoor workers, welders, semiconductor fabrication workers, television and theater personnel, tanning salon clients),[12] such studies have not examined farmworkers. Our study was designed to add to the occupational health literature for farmworkers by (1) describing the prevalence of eye symptoms among farmworkers; (2) documenting the prevalence of eye protection use among farmworkers; and (3) determining the barriers to the use of eye protection in this population.

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