May 5, 2010

VII. Health and Safety

It’s not the same as someone who works in McDonald’s for minimum wage because this kind of work wears your system out. You’re exposed to harsh nature, pesticides, all other kinds of chemicals, herbicides, fungicides. Farmworkers are the first line of contact.
—Josie Ellis, registered nurse and director of Vecinos Inc. Farmworker Health Program, Sylva, North Carolina, August 4, 2009

Working with sharp tools and heavy machinery, exposed to chemicals and extreme temperatures, climbing tall ladders, lugging heavy buckets and sacks, children get hurt and sometimes they die. Agriculture is the most dangerous industry open to young workers, according to the Centers for Disease Control’s National Institute for Occupational Safety and Health (NIOSH),[105] and the rate of occupational fatality for all workers in crop production was almost nine times the national average in 2008.[106] From 2005 to 2008, 43 children under age 18 died from occupational injuries in crop production—27 percent of all children who were fatally injured at work during this period.[107] In 2000, the most recent year for which data are available, the risk of fatal injuries for all agricultural workers ages 15 to 17 was 4.4 times that of young workers in other workplaces.[108]

Other common health hazards of agricultural work include fungal infections, contact dermatitis from plants and chemicals applied to them, hearing loss from proximity to loud agricultural machinery, eye injuries and irritations, and transportation injuries while traveling to and from work and between fields.[109]

In interviews with Human Rights Watch, children routinely described small accidents, and some more serious. Rarely did they say they sought medical care. Underreporting of injuries is, in fact, substantial, and it is argued that traditional sources of data are not reliable.[110] “I see a lot of them get hurt,” a community health worker in Florida told us.”[111]

According to NIOSH, young workers’ “biologic, social, and economic characteristics” cause them “unique and substantial risks for work-related injuries and illnesses.”[112] These characteristics include rapidly growing “organ and musculoskeletal systems, which may make them more likely to be harmed by exposure to hazardous substances or to develop cumulative trauma disorders”; and less experience, training, and knowledge about how to work safely, what their rights are, and what they are not legally allowed to do.”[113]

In addition to injuries actually suffered on the job, farmworker children’s health is also affected by substandard farmworker housing, low incomes that result in poor diet, pregnant farmworkers’ exposure to pesticides and lack of access to adequate prenatal health care, and mental health problems related to poverty, migration, and drug and alcohol abuse in farmworker camps.[114]

Work with Dangerous Machinery, Equipment, and Tools

Children described working with heavy machinery, using knives and chainsaws, and climbing tall ladders to pick fruit. As noted throughout this report, US law allows children to do hazardous work in agriculture at age 16, compared with an age limit of 18 for all other hazardous jobs.

Tractors, trucks, and other heavy machinery

Children may legally drive tractors of over 20 horsepower take-off at age 16, and at age 14 if trained and certified.[115] Tractor overturns were the leading cause of death for all farmers and farmworkers who died from work-related injuries between 1992 and 2007.[116] As discussed below, roll-over protective structures greatly improve tractor safety but were missing from 41 percent of tractors in 2006.

Human Rights Watch interviewed several boys ages 16 and older who said they drove tractors.[117] Jose M. described his work, which also involved hitching a wagon to the trailer, an activity that is recognized as carrying additional risks: “I hook up the trailer wagon and go to the field,” he explained. “I organize the boxes in the wagon so they don’t fall off on the way to the barn. I do the hitching. You could easily break your arm hitching. You have to know how close you’re getting to the wagon so you don’t hit it.”[118]

Children are also at risk of getting struck by, run over, or entangled in other machinery. Jose M. described being in an accident when the trucks transporting the workers to an onion field collided: “The back window of the truck broke on our heads. I fell off the truck. My mom hurt her knee. My aunt and uncle got hurt. . . . I had lots of cuts on my head from the broken glass. I got stitches.”[119]

Other reports of children’s work-related deaths include:

  • In December 2007, 17-year-old Edilberto Cardenas died on his first day on the job picking oranges in Florida. According to the sheriff’s department, he climbed off a ladder to empty a bag of oranges in a loading basket and a truck backed into him.[120]
  • In December 2006, a 10-year-old boy accidentally ran over his 2-year-old brother while driving a pickup truck pulling a trailer that his parents were filling with oranges in a Florida grove.[121]
  • In early summer 2004, a 12-year-old boy working for hire in Iowa was crushed between a hay wagon and a truck bed as he was hitching the wagon to the truck.[122]
  • On August 15, 2002, a 14-year-old farmworker in Ohio died after falling into a cattle feed grinder/mixer. The boy was using a handheld hay hook to drop hay bales into the operating grinder from the top of a stack of hay bales. He apparently lost his footing, slipped, and fell into the grinder.[123] Children under the age of 16 may not legally operate or help operate a feed grinder.[124]

Knives, chainsaws, and other sharp tools

[When I was 12] they gave me my first knife. Week after week I was cutting myself. Every week I had a new scar. My hands have a lot of stories. There are scars all over.
—Jose M., age 17, Saline, Michigan, August 24, 2009

Children regularly work with sharp tools, from hoes and kitchen knives to chainsaws. Sometimes they cut themselves. Children under the age of 16 may not legally operate a power-driven circular, band, or chain saw.[125]

Children cutting kale and collard greens in southeastern Michigan showed us fresh cuts they got through their gloves. Robert L., whose hands were laced with scars, said he had been cut “so many times” cutting greens. He worked with a 6-inch knife. “You’re bound to get sliced,” he said.[126] Andrea C. showed us two fresh punctures and said, “I poke myself. A bunch of blood comes out. . . . My brothers when they were still here, one got cut bad. A lot of people get cut. Sometimes you get so close to chopping your finger off! Sometimes you’re going really fast and you don’t notice and ah!”[127]

Hector H. in Texas showed us an inch-long scar on his knuckle that he said he got working in Ohio the year before while making boxes to pack corn: “There was a thin string, I put my hand under a box. . . . I went to the hospital the same day and then came back and worked. I got four stitches. It happened about 9 or 10 a.m. I finished at the hospital about 11. I was making boxes but I couldn’t move my thumb . . . but the guy told me to go to work.”[128]

Lucas F. said he cut his finger in a Michigan packing house: “When the beans come out on the shaker, they shoot into the machine that cuts the beans. Sometimes the machine gets stuck and you have to pull it back. A bunch of people cut themselves.”[129] Maria M. from Idaho described using a small knife while weeding sugar beets. “If you wanted to work fast you would use a knife. . . . It’s not always safe because if you’re kneeling down you have to be careful not to cut yourself. I wrapped it with a sock.”[130]

In North Carolina, Marcos S., quoted above, said he first cut Christmas trees with a chainsaw at age 12, and used one regularly from age 13.[131]

Ladders

Children described climbing tall ladders carrying heavy containers to pick fruit. In the mornings, trees and ground are often wet with dew. Workers often place one foot on a branch or use the top two steps of the ladder to extend their reach, and pick with one or both arms over their head reaching for fruit.[132] A young man who picked cherries, pears, and apples around Yakima, Washington, as a teenager said: “You carry 20-30 pounds in your bag. . . . In the morning it’s pretty wet and the ladder gets wet. If you take a wrong step, you’re down from the ladder. They’re 13-foot ladders so they’re pretty high.[133] A boy who had picked oranges in Florida told us: “It’s really high. When we didn’t have ladders, I had to climb the trees. Twice I fell from the top of a ladder. I grabbed a branch and broke my fall.”[134] Children under the age of 16 may not legally work from a ladder at a height of more than 20 feet.[135]

Failure to use protective gear

Human Rights Watch researchers saw many children working without gloves and some, including a 10- and a 12-year-old, working barefoot. Most said no one required them to wear protective gear; if anyone, it was their parents, not their employers.

Some children told us that gloves were uncomfortable, cumbersome, or bruised the fruit. Raul L. explained why he did not wear gloves while picking mint as a teenager in Idaho: “Sometimes it hurts your hands, but gloves are really uncomfortable and the plant is very slippery. Especially early in the morning, it’s hard to get the plant out. But at the end of the day my hands really hurt from pulling those weeds out all day long.”[136] Julia N., who worked as a teenager in California, said: “I used gloves but cut the fingers off because otherwise you bruise the fruit and they don’t pay you. There are kinds without spines and others with strong ones and they stick you. Your fingerprints have a lot of little cuts from the spines. And if you forget your gloves then your arms get really scratched.”[137] Even with gloves, children cutting greens in Michigan said they still cut themselves, as recounted above.

Many children said their parents made them wear long pants and long sleeves but some did not. Pedro E. described working in Georgia in 2008: “The first day I was burned. I was in short sleeves and shorts. I thought, ‘Thank God I got through it.’”[138]

Repetitive Motion Injuries

When I did strawberry roots, you have to bend down all day. It would kill your back.
— Marcos S., age 17, Sylva, North Carolina, August 4, 2009.

Children described working bent over at the waist, on their knees, with their arms up in the air, or otherwise holding awkward positions, all day long, five to seven days a week. They often perform prolonged repetitive motions and lift heavy weights. They told us about pain in their backs, knees, hands, and feet, even at very young ages. Children whose bodies are still developing are especially vulnerable to repetitive motion injuries.[139]

Luz A. said that when she picked strawberries in Florida at age nine: “It was hard—you have to be bent over and afterwards your back hurts. You don’t feel the pain at work but afterwards your back hurts.[140] Lucas F., who first worked pulling asparagus at age 12, described the work as “backbreaking,” sitting on a “rider” with his feet on two bars, leaning over to pick asparagus between his legs.[141]

Raul L. remembered weeding in Idaho: “You kneel down. It was really painful sometimes. It’s hard on your back, but I didn’t feel I needed to go to the doctor because of the pain—it would go away someday. Sometimes I had a lot of pain in my hands, back, feet. Sometimes you would get all wet from your waist to your feet. It was really tough on my feet because I didn’t change socks, and at night sometimes it was hard to sleep because of the pain in my feet.”[142]

Musculoskeletal disorders are usually caused by “an accumulation of microtrauma” without sufficient time to recover.[143] These disorders constitute nearly half of all agricultural occupational illness and injuries in the United States.[144] A study of farmworkers in the eastern United States found that farmworkers were most affected in the neck, shoulders, and upper extremities.[145] A doctor who cares for farmworkers told us that he was treating 29- and 30-year-olds for knee pain that he attributed to their starting farmwork at young ages.[146] Although treating repetitive motion injuries typically requires rest, as well as anti-inflammatories, splinting, physical therapy, and rehabilitation, farmworkers are under pressure to keep working at the same rate and, as noted below, often lack access to medical care.[147]

Pressure to Work Fast, Sick, and Injured

I can’t afford to miss any day. Half of my family depends on the money I earn. My money counts.
—Jose M., age 17, Saline, Michigan, August 24, 2009
It’s hard to say what hurts the worst,” “My legs hurt, my head hurts from the sun. [Today] I’ve had 3 bloody noses. I feel dizzy and then my nose is bleeding.
—Walter R., age 17, who had spent the day working in tobacco, Goldsboro, North Carolina, August 6, 2009

Children routinely told us they felt pressure to work as fast as possible, with few breaks, and to keep working even when injured or when sickened by pesticides, heat, tobacco, colds, flu, or other illnesses. “We can’t get sick because then we can’t work,” said 15-year-old Mary J.[148]

When paid on piece rate, the faster they work, the more workers get paid.[149] When paid by the hour, children said they were afraid of falling behind and getting fired. The pressure children feel to work quickly combined with simply less work experience can increase the risk of accidents.

“I have to be fast,” explained a 17-year-old tractor driver. “Bring [the load] all the way to the barn and then get [more]. There is pressure there that makes you go faster. If I don’t hurry, I’m losing boxes.”[150] And Elisabeth S. said of working during her high school years: “The main thing is not being left behind because the boss pays attention to you. You help your friends so they don’t get fired. The whole time you’re living in fear that you’re going to get fired. . . . It was like a race all the time.”[151]

A 15-year-old girl told us: “I get sick and throw up a lot in Michigan. My stomach and my head hurt. It’s because of the sun. When I’m picking I feel sick. . . . If my dad sees I’m really sick he makes me come home and rest. But then he gets really behind because we’re a lot of help to him. So if I leave it’s a lot of work. I feel down because I know my dad is going to have to work even harder.”[152]

Jose M., whose accident while being transported to the fields is described above, told us that he and his injured family members nevertheless returned to work the following day: “The next day we were out in the field. It’s an unexplainable feeling. You have to try not to miss any day.”[153]

Pesticide Exposure

Here there are a lot of chemicals in the field. . . . You can smell them. [Recently] the plane sprayed, sprayed the cotton. . . . I felt dizzy. I covered my face and kept working. No one told us to get out of the field.
—18-year-old Hector H., who worked from age 8 or 9 and works alongside children, Plainview, Texas, July 20, 2009
Pesticides are poisons. If you’re sprayed, it’s always bad.
Dr. Thomas A. Arcury, Director, Center for Worker Health, Wake Forest University School of Medicine, October 19, 2009

Exposure to pesticides is a serious risk for all farmworkers and even more so for children. Most children we interviewed said they had had contact with pesticides, many through pesticides being sprayed in fields next to them and blown by the wind, and through contact with residue, sometimes still wet. Some children reported being sprayed directly. Almost none of the children said they had received training on pesticide safety.

As discussed in more detail below, children under age 16 are not legally allowed to handle or apply pesticides classified as category I or II of toxicity but may handle less toxic pesticides. Regulations prohibit the spraying of pesticides when any unprotected worker is in the field or may be exposed through drift, and require workers to be trained in pesticide safety but make no special consideration for children.

Children’s exposure to pesticides

Pesticides widely used in agriculture include insecticides, herbicides, fungicides, fumigants, nematicides, rodenticides, and plant growth indicators.[154] The most widely used insecticides are neurotoxins.[155] Pesticides vary in toxicity and enter the body primarily through absorption through the skin, although they can also be ingested or inhaled.[156]

Although everyone who works on a nonorganic farm is exposed to pesticides, the degree of exposure depends on the farm’s safety and hygiene practices: exposure includes both the amount of pesticides with which farmworkers come into contact as well as the dose that actually enters their bodies, which is affected by the use of protective equipment and clothing, washing, and other factors.[157] Relatively little research on farmworkers’ pesticide exposure has been conducted anywhere in the United States and even less so on working children.[158]

Andrea C. in Michigan said that on the farm where she works, pesticides are sprayed from a tractor: “Sometimes we’re passing by and they’ll spray anyways.”[159] Sam B. in Texas told us he was sprayed from an airplane the previous year.[160] A former child farmworker in North Carolina who now educates workers about pesticides told us that she had personally seen tobacco workers being sprayed with pesticides: “People don’t leave. . . . People say, ‘We can leave but we don’t want to because we’re afraid the patron [boss] will fire us.’ They stay there because they’re afraid of their patron.”[161]

More common than direct spraying was exposure when the wind or run-off spread pesticides to nearby areas, known as “drift.” “They sprayed the field next to us yesterday,” said Andrés F. in North Carolina. “My head hurt. I could smell it, it blew. We kept working. Many people say this can, can hurt you. I’m a little, a little worried about it. Sometimes I put on gloves. When I don’t use gloves, it feels irritated.”[162]

Noemi J. in North Carolina told us she did not like working tobacco because of pesticides: “Sometimes you’re in one field and you see people in the next field spraying. It gives me headaches. I’m allergic. I think, ‘You could have at least waited until we left!’”[163] And Elias N. in Texas said: “A few days ago they sprayed the fields in the front. [The plane] passed by and we were starting to get out, but it just passed one time so we kept on. I got a headache. I could hardly hit the weeds but I kept on. It was about a quarter mile away. The wind was going to us and I could smell it and got a headache. It was in the wind.”[164]

Most children described seeing residue on plants while working in the field. Some children described being kept out of the fields after pesticide application; others said they worked while the fields were still wet with chemicals. The account of a boy in Michigan is typical: “Countless times we’ve been in the fields when they’re still wet [with pesticides]. Also, the boss says take the day off because it’s too wet.”[165] Even if workers are kept out of the area for the legally required time period, known as the restricted-entry interval (REI), pesticides are still present in the fields at lower levels.[166]

Children of farmworkers, in addition to any occupational exposure, are also exposed to pesticides brought home on parents’ bodies, that drift during and after nearby applications, in farmworker housing, prenatally, and through breastfeeding.[167] For example, Human Rights Watch interviewed a 17-year-old girl five months pregnant who was alternating daily between working in tomato fields and taking care of children.[168]

The impact of pesticide exposure on children

Children are uniquely vulnerable to chemicals and may absorb pesticides more easily than adults because they have a higher skin surface area to weight ratio, faster metabolisms, and ongoing development.[169] Direct spraying is not necessary to poison a child; contact with treated surfaces can provide enough exposure.[170]

Exposure to pesticides has both immediate and long-term effects. Small doses can produce rash, dizziness, nausea and vomiting, headaches, muscle aches, and burning eyes.[171] Large doses can cause loss of consciousness, coma, and death; exposure can also cause spontaneous abortion and birth deformities.[172] The Environmental Protection Agency estimates that 10,000-20,000 physician-diagnosed pesticide poisonings occur each year among US agricultural workers.[173] This number represents only a small fraction of actual pesticide poisonings as many cases are never reported.[174] Although exact numbers of poisoned children are not available, research indicates that children working in agriculture have far greater incidence rates of acute occupational pesticide-related illnesses than children working in other jobs.[175]

The long-term effect of pesticide exposure is not well documented, particularly at low levels. However, it is associated with chronic health problems such as cancer, neurologic problems, hormonal and reproductive health problems, and infertility.[176] According to Dr. Thomas Arcury, director of the Center for Worker Health at Wake Forest University School of Medicine, “The accumulated knowledge from animal studies and ecological studies all indicate that long-term low level exposure is a problem and that we need to do a better job of protecting people from pesticides.”[177]Subclinical long-term health effects that may not be readily diagnosed include memory loss and, in children, retarded neurobehavioral development.[178]

Many children we spoke with described symptoms consistent with pesticide poisoning, although some did not realize it at the time. Raul L., who worked as a child in Idaho, told us: “They have the canal with water at the end of the field and they put the chemicals in the water and they get these pipes and pipe water into the fields for corn, sugar beets. . . . Our feet would get all big with mud. So when we would go to eat, we’d go and wash our feet with our hands [in the canals] and then in the afternoon I’d get the rash. . . . I would get a lot of itchiness. My feet would get red, rashy. At that time I didn’t know about types of chemicals—no one told us.”[179]

Julia N., who later trained farmworkers on pesticide safety, described her experience working as a child in California: “One time I took off my bandana and gloves and experienced the symptoms of pesticides. . . I had an itchy face, blurry eyes, I got very dizzy.” Julia said that she did not associate her symptoms with pesticide exposure until she was trained for her current job. “I feel so bad that I didn’t know and that so many people don’t know that if they take off a glove that could expose them to pesticides and they’ll have so many problems, like cancer,” she told us. “I think about this, that I [got exposed and my mom did] and I’m so afraid that one day she’s going to get sick or something will happen to her from pesticides.”[180]

Luz A. told us that when she picked blueberries every year in Michigan: “I got sick because when I was in the fields, I took in the chemicals they put on the plants. . . . My stomach was always heaving. Every single day. I was really sick. . . . I think [what made me sick] was the pesticides they put on the plants. The smell of it, and on the blueberries you could see that they have something on them. You could see it all around, and you were breathing it. I’d still be out there all sick because I had to help my mom because we didn’t have that much money.”[181]

Pesticide training and protective gear

[Pesticides] are there but I don’t know about them.
— Nelson I., age 17, Plainview, Texas, July 20, 2009
They don’t tell us anything.
— Noemi J., age 16, responding to a question about pesticide training, Goldsboro, North Carolina, August 6, 2009

Most children Human Rights Watch interviewed said they had never received training on pesticide safety and took few precautions.[182] Some children who said they had not received formal training still described good practices such as washing their work clothes daily, showering right after work, and wearing long pants and sleeves.

For example, 14-year-old Alejandro P. said he worked in “short sleeves, jeans, sneakers and gloves so my hands don’t get dirty.”[183] As noted above, Human Rights Watch saw children working barefoot and without gloves, and a health outreach worker said, “We talk with people who go to work barefoot or with no shirt.”[184] According to experts on farmworkers and pesticides: “In most fieldwork situations, the appropriate pesticide PPE [personal protective equipment] for farmworkers is work clothing that covers the head, body, arms, legs, and feet; that is a hat, a long-sleeve shirt that is closed around the neck, long pants, socks, and closed shoes.”[185] A 2003 study found that of the studied cases of pesticide-related illness in which relevant information was available, only 19 percent of children who were employed in agriculture had used protective equipment (9 of 48) and only 25 percent of children who had directly handled pesticides had used personal protective equipment.[186]

Research in several states, including North Carolina and Texas, has found that from about one-quarter to one-half of workers surveyed have received no pesticide safety training.[187] Sam B., who said he trained other workers, was unaware that regulations prohibit any unprotected worker from being in a field when pesticides are applied: “Sometimes the airplane will be spraying pesticides around. We have to ask the crew leader if they are poisonous or not. One time last year an airplane passed over and sprayed us, and we didn’t know if it was poisonous or not.”[188] Alejandro P. told us, “I don’t know if there are pesticides or not.”[189]

In contrast, children in several areas of Michigan said their employers had shown them a pesticide training video, and a farm operator pointed out the video in Spanish and in English on pesticide training that he said he shows to his workers. Mauricio V. said that the second year he worked in Idaho his crew leader showed a pesticide video after nearby workers were poisoned:

An onion field was sprayed with a certain pesticide. It was still visible and smelled and the workers were told to go back to work, and they didn’t want to because they could see the plants were white. Some didn’t, others did because they needed to work. Within an hour some were coughing up blood. . . .
After that the crew leader showed us a pesticide video but before that none of us had ever seen one. It was basic safety: don’t get the pesticides on you, don’t get water from irrigation canals. . . . It was actually pretty good. It’s just a kind of evil that the reason we were watching it was because that already happened.[190]

Pesticide training for child workers is especially important because, as one study stated, “Young people are generally less experienced and assertivethan adults, and thus they may not question assignments thatplace them at risk for pesticide exposure.”[191]

Several agencies are working to improve pesticide safety training for farmworkers. For example, the US Environmental Protection Agency (EPA) has developed extensive training for state pesticide safety inspectors and for workers, including in multiple languages and in pictorial guides. But “[w]hether or not it’s being used as it should be is a different question,” staff acknowledged.[192] The Association of Farmworker Opportunities Programs (AFOP) also conducts pesticide safety programs for farmworkers under grants from the EPA and AmeriCorps in 24 states.[193]

Training alone, however, will not address the many factors outside of workers’ control, such as growers who force workers into fields with fresh residue or who fail to provide sanitation equipment that can decrease the dose absorbed. “What does it matter if they wear long sleeves, bandanas if they have to go back into the field right after it’s been sprayed?” noted a North Carolina health outreach worker.[194] Similarly, Carol Dansereau, of the Seattle-based Farm Worker Pesticide Project, stated: “a lot of attention has gone into ‘educating’ farm worker families about ‘hygiene’ to reduce exposures. While it certainly is important to let people know about things one can do to try to reduce exposures, it is appalling that this is the emphasis, to the exclusion of ending the source of the problem . . . nearby applications of highly toxic chemicals.”[195] Seventeen-year-old Andrea C. also pointed out that while she “learned a lot of things” from the video, “It’s dumb, they make us see it but they don’t enforce it. Like restrooms. We have portables but not the water it takes to wash, soap, towels. The first day they did the soap and filled the towels. Now we want soap and towels. You tell them and they say, ‘So?’ They don’t care.”[196] As noted above, Andrea also told us that she had been sprayed with pesticides from a passing tractor. Mauricio V., a former child worker, commented on the power imbalance that resulted in some workers returning to the Idaho field when ordered to do so: “It was so terrible to hear about it because when it comes down to it you really need to work. You’ll work, you’ll work.”[197]

Extreme Temperatures: Heat and Cold

Children work in extreme heat and extreme cold. In some climates the day starts cold and wet, then turns unbearably hot. “When you wake up it’s really cold,” said James A., who works in Michigan in the summer. “The plants hurt your hands because it’s so cold. Your hands get numb.[198] One mother with working children described picking apples in Michigan in waist-high snow.[199]

In contrast, temperatures in the Texas panhandle can reach well over 100 degrees Fahrenheit in the summer, and children spoke of longing for jobs in air conditioning. Elias N. said that when he’s working: “I think of the sun, why it’s so hot. How I want to go home from this field.… [I]t’s the hot air and the sun is beating you up. . . . [Bad days are the] real hot ones, the field is full of weeds, you can’t even take a step. When you’re surrounded by corn, there’s no air.”[200] Elisabeth S., who worked in Washington as a teenager, told us: “It was so hot that I didn’t want to touch my clothes.”[201]

Working long hours in high temperatures places children at risk of heat stroke and dehydration, particularly if there is not enough drinking water and they are wearing extra clothes to protect them from sunburn and pesticide exposure. “It’s just really hot and the water gets hot. You get really, really thirsty,” Marta V., age 13, said.[202] Sam B. told us: “The first year I worked, the second week, I got dehydrated. My dad had to bring me water. Sometimes you feel dizzy but you’ll come back. . . . You get all dehydrated and you want to faint but you need the money. Sometimes I think, why am I here? I can get a better job. But it’s not true. . . . I’ve seen women, guys get dehydrated quick. Faint. They’ll just give up like that.”[203]

Heat illnesses can lead to brain damage and death. From 1992 to 2006, 68 crop workers were formally recorded as having died from exposure to environmental heat, a rate 20 times that of all US civilian workers.[204] Children are significantly more susceptible to heat stress than adults.[205] 

The deadliness of heat illness and the difficulty in treating a worker once the illness has progressed to a critical stage is well demonstrated by the death of Maria Isabel Jiménez. On May 13, 2008, 17-year-old Jiménez collapsed after working for nine hours straight in the heat. By the time she reached the hospital, her core body temperature exceeded 108 degrees and she died two days later.[206] The autopsy report gave “Heat Stroke/Sun Stroke due to Occupational Environmental Exposure” as the cause of death. The state of California fined the labor contractor more than $250,000 and revoked her license; in 2009, the contractor and Jiménez’s supervisor were charged with involuntary manslaughter for failing to provide Jiménez with reasonable access to potable water, shade, heat illness training, and prompt medical attention.[207]

Sanitation

Many children said that their employers did not provide drinking water, handwashing facilities, or toilets.[208] As noted below, the Occupational Safety and Health Act requires that agricultural employers with more than 10 employees provide drinking water and toilet and handwashing facilities for farmworkers while they are working.

Access to drinking water is critical to preventing heat injury: workers may need one half to one quart of water per hour as the temperature increases from 80 to 90F.[209] Girls and women may also be at risk of urinary tract infections.[210] Strikingly, the mother of two teenage children hoeing cotton with no toilets or provided drinking water told us, “We don’t go to the bathroom because we sweat.”[211] Frequent handwashing, especially before eating and using the toilet, is critical for reducing the dose of pesticides entering the body following exposure. The absence of field toilets may also increase the risk of gastrointestinal disorders.[212]

Drinking water

I have never worked where we had water. In my time we’ve always had to carry our own.
—Mother of 10- and 11-year-old working children, Plainview, Texas, July 20, 2009

Many children said they had to bring their own drinking water, buy it in the fields, or do without. A 15-year-old girl told us that in Michigan: “You take your own water. If you run out they allow you to go home and get some.” In Florida, she said, they “sell it to you. Water is $1.”[213] Elisabeth S., who worked with a team of teenagers in Washington State, explained: “If we ran out [of water] we ran out. They [employers] didn’t fill it up. Occasionally if people complained they would fill it, but because we were all kids we would just stay quiet. In Spanish culture we’re taught that whatever the authority says, goes. If there’s no water, well, they know, so we’re not going to say anything.”[214]

Some children in Texas and Michigan said that they not only had to bring their own water, the tap water in the camps or their communities was so poor they had to buy the water they brought. For example, a 14-year-old girl living in migrant housing in Texas told us: “We bring our own water. We buy our own water and fill it [the cooler] up.”[215] A 10-year-old boy said that early each morning before work, his chore is to buy water “from the machine at Lowe’s beside the house.”[216]

Toilets and handwashing facilities

You don’t wash your hands to eat. You just take off your gloves. They had a weird smell. . . . I don’t know anyone who washed their hands. There was no place to.
— Elisabeth S., age 19, who worked in Washington State while in high school, August 3, 2009

Many workers we spoke with said there were no toilets or handwashing facilities in the fields, although this varied by location and crop. For example, children hoeing cotton in the Texas panhandle said they almost never had these facilities provided. “There’s no place to wash hands,” a 14-year-old hoeing cotton in Texas said. “We bring tap water and wash our hands.” When asked if there were portable toilets, she responded, “No, only during pumpkin season in October.”[217] A mother who took her children to hoe cotton said she wished for portable toilets. Her 10-year-old son, she said, “had diarrhea one day behind the wheel [of the car] and we forgot toilet paper. He was trying to hide behind the wheel of the car.”[218]

In contrast some children in Michigan said they had toilets, and Human Rights Watch saw some in the fields, although not necessarily at the distances or conditions required by regulation.[219] In some studies farmers have reported it “difficult to move toilet and washing facilities to all of the fields where they employ workers,” that “when they do provide sanitation facilities, such as field toilets and washing stations, workers do not use them,” and that they “consider this requirement to be burdensome.”[220]

Green Tobacco Sickness

Acute tobacco poisoning, known as “green tobacco sickness,” is an additional risk to working in tobacco, and children are especially vulnerable. The poisoning occurs when workers absorb tobacco through the skin as they come into contact with the leaves; wet leaves increase the risk of poisoning as nicotine dissolves in the water on the leaf’s surface. Physical exercise and high ambient temperatures can increase absorption of nicotine as blood is shunted to the skin to help lower body temperature.[221] Symptoms include nausea, vomiting, headaches, muscle weakness, dizziness, abdominal pain, and diarrhea, as well as shortness of breath, and occasional fluctuations in blood pressure or heart rate.[222] According to a recent study, “on a humid day, especially after a recent rain, the average field worker may be exposed to as much as 600 mL of dew,” which would contain roughly the nicotine of 36 average cigarettes.[223]

“Topping” and harvesting, two types of tobacco work the children Human Rights Watch interviewed conducted, place workers in constant contact with tobacco leaves and at particular risk of green tobacco sickness.[224] Human Rights Watch interviewed 12 children working in tobacco in eastern North Carolina.

Children are especially vulnerable to green tobacco sickness compared with adults. Their bodies are smaller in size relative to the dose of nicotine they absorb, they typically lack tolerance to nicotine, and may be less well-informed about the risks, especially from rain or dew, because the danger is from the plant itself, not an obvious external substance.[225]

Protective clothing such as rain gear and water-tight gloves can protect workers from exposure but also increase the risk of heat exhaustion and dehydration;[226] none of the children Human Rights Watch interviewed mentioned wearing protective clothing.

Access to Health Care

Farmworkers generally have poor access to health care, and only 20 percent of migrant and seasonal farmworkers reported in 2000 using any healthcare services in the preceding two years.[227] A study of migrant families in eastern North Carolina, published in 2004, found that for over half of the children sampled, the child’s caretaker reported a time in the past year when the caretaker felt the child needed medical care but the child did not receive it.[228]

Cost is a significant problem. Farmworkers’ incomes place them near or below poverty, many are not eligible for Medicaid, and few have health insurance: 85 percent of migrant and seasonal farmworkers, and nine out of ten children in farmworker families, were uninsured in 2000.[229] Some simply cannot afford the lost wages of hours spent waiting for care or to apply for benefits; some may lose their jobs if they miss a day of work. Farmworkers are also not covered by workers’ compensation laws in many states.[230]

There are approximately 160 federally funded migrant health clinics as well as community clinics that receive federal funding to care for uninsured and under-insured migrant farmworkers and their families.[231] While many of these provide excellent care, they are not sufficient to cover all farmworkers’ needs. Language and distance from medical facilities are also significant barriers.[232] Where workers do receive care, health providers may have limited training in diagnosing occupational health problems, including pesticide exposure, and may face cultural barriers in providing treatment.[233] The Migrant Clinicians Network has programs to promote the integration of occupational and environmental medicine into primary care.[234]

Some children told us their employers had paid for their emergency care for a minor workplace injury but strictly on an ad hoc basis. More common were descriptions of problems persisting for years without formal medical treatment. “When they’re really sick, unless they’re in pain,” they are not going to go to the doctor, a health worker told us.[235]

The new health care reform law recently enacted by the US Congress excludes undocumented workers from coverage. As noted earlier, it is estimated that about half of all farmworkers are undocumented. 

Sexual Harassment and Violence

From California, where the fields were called “ field de calzon (or “field of panties”) because so many supervisors raped women there, to Florida, where female farm workers call them “The Green Motel,” and throughout the country, we have found women working in agriculture are often particularly vulnerable to sexual harassment.
—William R. Tamayo, EEOC regional attorney, San Francisco district office, June 18, 2009[236]
All forms of workplace exploitation take their toll on victims, whether it is economic or sexual. One major difference that I have seen is that when you are raped at work it is not the same as not being paid; you are not just going to get another job and move on with your life like when you’re not paid. When you’re raped, it impacts the rest of your life. . . .
Farmworker victims are getting pregnant, they are getting STIs [sexually transmitted infections] from perpetrators, and they are suffering trauma from rape. It affects them and their families. Some victims I’ve represented have said they could no longer interact with their family in the same way afterward because they felt ashamed and embarrassed. The harm caused by sexual violence goes to the core of the person’s being. It’s a health issue, a safety issue, a civil rights issue.
—Mónica Ramírez, Esperanza: The Immigrant Women’s Legal Initiative of the Southern Poverty Law Center, December 30, 2009[237]

Farmworker women and girls are exceptionally vulnerable to sexual exploitation and violence by co-workers, crew leaders, labor contractors, and growers. This violence ranges from inappropriate or threatening comments to groping, sexual assault, and rape. In a recent survey of Latino immigrants in five states, 77 percent of women said that sexual harassment was a major workplace problem.[238] Similarly, farmworkers and advocates in Fresno, California, told EEOC staff “that hundreds, if not thousands, of women had to have sex with supervisors to get or keep jobs and/or put up with a constant barrage of grabbing and touching and propositions for sex by supervisors.”[239]

Maria M. from Idaho, whose story is recounted above, described her experience of being almost the only girl harvesting zucchini when she was in high school:

It was difficult . . .  when I was placed next to men. I wore really loose clothing. I never wore tight clothing because that would be a big mistake. There were times when you were working down the row and there’s a guy next to you asking your name. They never ask how old you are because they don’t want to know that. . . . You had to be rude to a guy even though they’re just asking your name because it could turn into something worse. . . . You had to strategize how you were going to answer questions to prevent them from talking to you.
I remember one crew leader, he would stand behind girls and look at them. It wasn’t ok for him to do that, but other guys laughed because he was a crew leader. He was the worst crew leader ever. . . .
Women know you don’t wear a t-shirt to work. . . . When you’re working in the fields you can’t avoid being harassed by guys because of what you’re wearing.[240]

Another young woman said that when she worked when she was 15 and 16 years old in Washington State, girls tried to stay together in groups to avoid harassment, especially after the lunch break when men would get high on drugs.[241]

In 2005, Olivia Tamayo became the first female farmworker to successfully challenge her employer in federal court for sexual harassment.[242] Tamayo testified that her supervisor, who carried a gun and a knife, raped her and threatened to kill her and her husband if she told anyone.[243] She reported the assault and threats to her employer in 1999, and a deputy sheriff interviewed her but did not find her allegations credible.[244]The EEOC sued on Tamayo’s behalf and charged that Harris Farms allowed her to work isolated in the fields and to endure co-worker harassment until, in March 2001, she felt compelled to quit her job, her primary employment for more than 15 years. The jury found Harris Farms liable for sexual harassment, retaliation, and the constructive termination of Tamayo.[245]In January 2005, a jury awarded Tamayo a nearly $1 million verdict against Harris Farms, one of California’s largest agricultural businesses.[246]

The prevalence of sexual violence is always difficult to measure accurately; the isolation and other vulnerabilities of farmworker girls and women make it more so in this context. According to William Tamayo, an EEOC regional attorney whose office has brought numerous sexual harassment cases (and no relation to Olivia Tamayo): “This happens behind closed doors. There are probably scores of women and girls who are being raped in the fields every day but don’t come forward. They’re scared. . . . My view is that we’re just scratching the surface here.”[247]

Geographic, linguistic, and cultural isolation combined with poverty and a desperate need for work, poor housing, vulnerability to deportation if undocumented, and the inability to seek protection create a perfect climate for sexual harassment and violence to flourish on farms. Farmworkers typically work in less populated, more isolated rural areas; the majority of workers, supervisors, and employers are male. Victims may not speak English or know the abuse is illegal; they simply endure sexual harassment as part of the job. “People don’t know their rights. Predators are rarely punished,” said EEOC attorney Tamayo.[248]

The power differential between growers, contractors, supervisors, and workers is enormous. Workers may fear that they and their family members will be fired or face violence if they do report abuse. Maria M. told us: “it’s something that girls have to live with. I’m sure a lot of people wonder why a girl would go into the field in that situation, but you have to accept it’s going to happen and work is work.”[249] If the employer provides housing, being fired may mean becoming homeless. In addition, being fired could cause the victim or her family members to be blacklisted from agricultural employment in the area where the incident occurred or elsewhere because the worker is coined a trouble maker. As a result, the victim and even her family members can be denied future employment opportunities.[250]

Girls may be especially targeted and may be less likely to challenge their abusers than adults. “I never saw [sexual harassment] as an issue because I was used to it,” the young woman from Idaho explained. “Sometimes I would get frustrated, but it was something I knew was going to happen so I didn’t think it was a big deal until I learned it shouldn’t happen.”[251] Mónica Ramírez, founder and director of Esperanza: The Immigrant Women’s Legal Initiative of the Southern Poverty Law Center, who represents farmworker women and girls in cases involving sexual violence, said: “Children are always more vulnerable because they don’t know they have protections or how to protect themselves. Perpetrators take advantage of their youth, inexperience as employees, and lack of knowledge about their rights. Sometimes they make threats against the victims’ parents or other family members. Unaccompanied minors are also especially vulnerable.”[252] According to EEOC attorney Tamayo: “The imbalance of power is so great—kids don’t know their rights and they’re really scared. It’s usually 30- to 40-something’s who are propositioning or grabbing them—16-year-old girls.”[253]

Employers may ignore harassment or may themselves engage in abuse. “In cases I’ve handled,” Ramírez said, “it’s been supervisors and company owners who have committed the harassment. I am aware that some growers and supervisors say that they are aware of the problem but that it is not happening on their farm. They can’t say it’s not happening on their watch. It’s people in power who are perpetrating this violence.”[254] In other instances, the employer turns a blind eye or never receives the complaint. William Tamayo explained: “English-speaking owners are very dependent on labor contractors or foremen who speak Spanish. . . . Predators have so much power. They are the link to the employer. They are the lifeline. They are insulated. The employers are so dependent on these guys and so when problems are raised they don’t want to hear about it. They may think that the chances are rare that they will ever be prosecuted.”[255]

Women and girls have limited or no recourse for abuse. Local law enforcement may be unavailable or unreceptive to farmworker women’s and girls’ complaints. Where local and state police have signed so-called 287(g) agreements with Immigration and Customs Enforcement (ICE) allowing them to enforce federal immigration law, undocumented victims may, in effect, have no legal protection from crime because they fear complaining to the police will lead to their deportation (see below).

Aside from lacking information about their rights, farmworker victims often do not know about the community resources available to help them in the face of sexual harassment or violence. Social service providers may be far away from where the farmworker community members live or work. Such services may also only be available in English. Victims may fear that their partners and families will blame them for provoking abuse or for being perceived as causing problems. Thus, these victims may not tell even those closest to them. A paralegal who works with farmworkers said: “The women don’t want to talk about it. They don’t even tell their husbands. Because their husbands are going to blame them. So the woman says, ‘I don’t want anyone to know.’”[256]

One government agency that has specifically targeted this issue is the US Equal Employment Opportunity Commission (EEOC), which since 1996 has filed more than 20 cases of sexual harassment, retaliation, and sex-based discrimination on behalf of women agricultural workers, mostly out of its San Francisco office.[257] At the time of writing, only the Harris Farms case, described above, had resulted in a jury verdict, but at least 18 have resulted in settlements or consent decrees.

As an example of a recent case involving a teenager, in a lawsuit filed in January 2010 against Giumarra Vineyards,the EEOC alleged that a male co-worker subjected a teenage farmworker to “sexual advances, sexually inappropriate touching, and abusive and offensive sexual comments about the male sex organ,” that farmworkers who witnessed the harassment complained to Giumarra Vineyards, and that one day after the complaint, Giumarra Vineyards summarily discharged the girl and the farmworkers who complained in retaliation.[258] This case and others were still pending at the time of writing.

Several non-governmental organizations have also taken up the issue of sexual harassment and violence against farmworkers. These include Esperanza: The Immigrant Women’s Legal Initiative of the Southern Poverty Law Center (SPLC), the Agricultural Worker Health Project in conjunction with California Rural Legal Assistance Foundation and California Rural Legal Assistance, Inc., and the non-profit organization Lideres Campesinas. In addition, many organizations throughout the United States and abroad have partnered with SPLC on its Bandana Project Campaign.[259]

[105] NIOSH bases this statement on the fatality rate of workers between 1992 and 2000. NIOSH, “NIOSH Alert: Preventing Deaths, Injuries and Illnesses of Young Workers,” no. 2003-128, July 2003, p. 4.

[106]Bureau of Labor Statistics, US Department of Labor, “Fatal occupational injuries, total hours worked, and rates of fatal occupational injuries by selected worker characteristics, occupations, and industries, civilian workers, 2008,”

 http://www.bls.gov/iif/oshwc/cfoi/cfoi_rates_2008hb.pdf (accessed April 4, 2010). The fatality rate for all civilian workers in 2008 was 3.7; for “crop production” it was 32.5.

[107] Email from Sean Smith, Bureau of Labor Statistics, US Department of Labor, to Human Rights Watch, March 31, 2010 (citing preliminary data); Bureau of Labor Statistics, US Department of Labor, “2008 National Census of Fatal Occupational Injuries Preliminary Data,” http://www.bls.gov/iif/oshwc/cfoi/cftb0239.pdf (accessed April 21, 2010); Bureau of Labor Statistics, US Department of Labor, “2007 National Census of Fatal Occupational Injuries Preliminary Data,” http://www.bls.gov/iif/oshwc/cfoi/cftb0230.pdf (accessed April 21, 2010); Bureau of Labor Statistics, US Department of Labor, “2006 National Census of Fatal Occupational Injuries Preliminary Data,” http://www.bls.gov/iif/oshwc/cfoi/cftb0221.pdf (accessed April 21, 2010); Bureau of Labor Statistics, US Department of Labor, “2005 National Census of Fatal Occupational Injuries Preliminary Data,” http://www.bls.gov/iif/oshwc/cfoi/cftb0212.pdf  (accessed April 21, 2010). In total, 304 children and adults died from work-related injuries in crop production, and 34 children under age 18 died from injuries related to work in all sectors in 2008. Email from Sean Smith, Bureau of Labor Statistics, US Department of Labor, to Human Rights Watch, March 31, 2010 (citing preliminary data). Although Human Rights Watch could not obtain information about how many of the children who died in crop production during this time period were under age 14, by comparison, from 1998 to 2002, 9 of the 65 children under 18 died while working in crop production were under age 14. Notably, agriculture is the only sector in which work-related deaths were recorded for children under age 14 during this time period. Janice Windau and Samuel Meyer, Bureau of Labor Statistics, US Department of Labor, “Occupational injuries among young workers,” Monthly Labor Review, October 2005, p. 17, http://www.bls.gov/opub/mlr/2005/10/art2full.pdf (accessed April 4, 2010).

[108]US Department of Labor, Bureau of Labor Statistics, “Report on the youth labor force,” November 2000, p. 58, http://www.bls.gov/opub/rylf/pdf/rylf2000.pdf (accessed April 4, 2010).

[109] May, “Occupational Injury and Illness in Farmworkers in the Eastern United States,” Latino Farmworkers in the Eastern United States, Arcury and Quandt, eds., pp. 80-87.

[110] Ibid., pp. 71-72.

[111] Human Rights Watch interview with a community health worker, central Florida, March 23, 2009.

[112]NIOSH, “Young Worker Safety and Health.”

[113] NIOSH, “NIOSH Alert: Preventing Deaths, Injuries and Illnesses of Young Workers,” pp. 1-2.

[114] See, for example, Sara A. Quandt, “Health of Children and Women in the Farmworker Community in the Eastern United States,” Latino Farmworkers in the Eastern United States, Arcury and Quandt, eds., pp. 173-200.

[115] 29 C.F.R. sec. 570.72.

[116] NIOSH, “Agricultural Safety,” January 5, 2010, http://www.cdc.gov/niosh/topics/aginjury/ (accessed January 27, 2010).

[117] Human Rights Watch interview with Mike V. (not his real name), age 16, Plainview, Texas, July 20, 2009.

[118] Human Rights Watch interview with Jose M., age 17, Saline, Michigan, August 24, 2009.

[119] Ibid.

[120]“Teen grove worker hit by truck dies,” Orlando Sentinel, December 30, 2007, p. B3.

[121] Rick Rousos, “Citrus Grove Accident Torments Family,” The Ledger, January 12, 2007, p. A1.

[122]“12-Year-Old Farm Boy Dies While Hitching Up Hay Wagon,” NIOSH Fatality Assessment and Control Evaluation (FACE) Program, Iowa FACE, no. 04IA017, June 19, 2005, http://www.cdc.gov/niosh/face/stateface/ia/04ia017.html (accessed March 28, 2010). The investigative report noted that a “less experienced 12-year-old boy” might not have known techniques that “[e]xperienced farmers in this situation” might have employed to prevent the accident. Ibid.

[123]“Youth Farm Worker Dies After Falling Into Operating Feed Grinder/Mixer – Ohio,” NIOSH Fatality Assessment and Control Evaluation (FACE) Program, NIOSH In-house FACE Report 2002-10, November 20, 2003, http://www.cdc.gov/niosh/face/In-house/full200210.html (accessed March 28, 2010).

[124] 29 C.F.R. sec. 570.71(a)(3).

[125] 29 C.F.R. sec. 570.71(a)(3).

[126] Human Rights Watch interview with Robert L. (not his real name), age 16, Saline, Michigan, August 24, 2009.

[127] Human Rights Watch interview with Andrea C., age 17, Saline, Michigan, August 24, 2009.

[128] Human Rights Watch interview with Hector H., age 18, Plainview, Texas, July 20, 2009.

[129] Human Rights Watch interview with Lucas F., age 17, Walkerville, Michigan, August 26, 2009.

[130] Human Rights Watch telephone interview with Maria M., age 19, Idaho, September 13, 2009.

[131]Human Rights Watch interview Marcos S., age 17, Jackson County, North Carolina, August 4, 2009.

[132] May, “Occupational Injury and Illness in Farmworkers in the Eastern United States,” Latino Farmworkers in the Eastern United States, Arcury and Quandt, eds., pp. 88-89.

[133] Human Rights Watch interview with Tony P. (not his real name), age 19, Durham, North Carolina, August 6, 2009.

[134]Human Rights Watch interview with Andrés F. (not his real name), age 17, Benson, North Carolina, August 5, 2009.

[135] 29 C.F.R. sec. 570.71(a)(3).

[136] Human Rights Watch interview with Raul L. (not his real name), age 21, Durham, North Carolina, August 6, 2009.

[137]Human Rights Watch interview with Julia N., age 18, Benson, North Carolina, August 5, 2009.

[138] Human Rights Watch interview with Pedro E. (not his real name), age 15, Immokalee, Florida, March 25, 2009.

[139] NIOSH, “NIOSH Alert: Preventing Deaths, Injuries and Illnesses of Young Workers,”pp. 1-2.

[140] Human Rights Watch interview with Luz A., age 18, Plant City, Florida, March 21, 2009.

[141] Human Rights Watch interview with Lucas F., age 17, Walkerville, Michigan, August 26, 2009.

[142] Human Rights Watch interview with Raul L., age 21, Durham, North Carolina, August 6, 2009.

[143] May, “Occupational Injury and Illness in Farmworkers in the Eastern United States,” Latino Farmworkers in the Eastern United States, Arcury and Quandt, eds., p. 78.

[144]Bureau of Labor Statistics, US Department of Labor, “TABLE R1. Number of nonfatal occupational injuries and illnesses involving days away from work(1) by industry and selected natures of injury or illness, 2006,” November 8, 2007, http://stats.bls.gov/iif/oshwc/osh/case/ostb1793.txt (accessed April 15, 2010).

[145] May, “Occupational Injury and Illness in Farmworkers in the Eastern United States,” Latino Farmworkers in the Eastern United States, Arcury and Quandt, eds., pp. 78.

[146]Human Rights Watch interview with Matthew T. Standridge, family medicine physician and medical director of Vecinos Inc. Farmworker Health Program, Sylva, North Carolina, August 4, 2009.

[147] May, “Occupational Injury and Illness in Farmworkers in the Eastern United States,” Latino Farmworkers in the Eastern United States, Arcury and Quandt, eds., p. 78.

[148]Human Rights Watch interview with Mary J., age 15, Goldsboro, North Carolina, August 6, 2009.

[149] “The use of piece-rate pay strategies encourages inappropriate haste and shortcuts and may well heighten injury risk.” Ibid., p. 90.

[150] Human Rights Watch interview with Jose M., age 17, Saline, Michigan, August 24, 2009.

[151] Human Rights Watch interview with Elisabeth S., age 19, Durham, North Carolina, August 3, 2009.

[152] Human Rights Watch group interview with 15-year-old girl, 10-year old boy, and 9-year-old girl, central Florida, March 22, 2009.

[153] Human Rights Watch interview with Jose M., age 17, Saline, Michigan, August 24, 2009.

[154] Thomas A. Arcury and Sara A. Quandt, “Pesticide Exposure Among Farmworkers and Their Families,” Latino Farmworkers in the Eastern United States, Arcury and Quandt, eds., p. 104.

[155] These include organophosphorus and organochlorine pesticides. Most workers now are exposed to nonpersistent pesticides, which are metabolized in the body within a few days, compared with older pesticides which remain in the body and environment for a long time. Ibid., pp. 104, 122.

[156] Ibid., p. 104.

[157] Ibid., pp. 104-106. Farmworkers and their family members, including children, are also exposed in their homes, which may be contaminated through years of drift, accumulated pesticides brought in through contaminated clothing and containers, and application in the homes, particularly in dilapidated, pest-infested housing. Ibid., and see, for example, Quirina M. Vallejos, Sara A. Quandt, and Thomas A. Arcury, “The Condition of Farmworker Housing in the Eastern United States,” Latino Farmworkers in the Eastern United States, Arcury and Quandt, eds.

[158] Arcury and Quandt, “Pesticide Exposure Among Farmworkers and Their Families,” Latino Farmworkers in the Eastern United States, Arcury and Quandt, eds., p. 120. For more information about existing research, see ibid., pp. 121-122; Thomas A. Arcury et al , “Seasonal Variation in the Measurement of Urinary Pesticide Metabolites among Latino Farmworkers in Eastern North Carolina,” International Journal of Occupational and Environmental Health, vol. 15 (2009), pp. 339-350; and Thomas A. Arcury et al, “Variation Across the Agricultural Season in Organophosphorus Pesticide Urinary Metabolite Levels for Latino Farmworkers in Eastern North Carolina: Project Design and Descriptive Results,” America Journal of Industrial Medicine, vol. 52 (2009), pp. 539-550.

[159] Human Rights Watch interview with Andrea C., age 17, Saline, Michigan, August 24, 2009.

[160] Human Rights Watch interview with Sam B., age 17, Plainview, Texas, July 21, 2009.

[161]Human Rights Watch interview with Julia N., age 18, Benson, North Carolina, August 5, 2009.

[162]Human Rights Watch interview with Andrés F., age 17, Benson, North Carolina, August 5, 2009.

[163] Human Rights Watch interview with Noemi J. (not her real name), age 16, Goldsboro, North Carolina, August 6, 2009.

[164] Human Rights Watch interview with Elias N. (not his real name), age 16, Plainview, Texas, July 21, 2009.

[165] Human Rights Watch interview with Jose M., age 17, Saline, Michigan, August 24, 2009.

[166] Arcury and Quandt, “Pesticide Exposure Among Farmworkers and Their Families,” Latino Farmworkers in the Eastern United States, Arcury and Quandt, eds., p. 108.

[167] Email from Carol Dansereau, Farm Worker Pesticide Project, to Human Rights Watch, July 17, 2009.

[168] Human Rights Watch interview with Marisol G. (not her real name), age 17, Jackson County, North Carolina, August 4, 2009.

[169]Geoffrey M. Calvert et al, “Acute Pesticide-Related Illnesses Among Working Youths, 1988–1999,” American Journal of Public Health, vol. 93, no. 4 (April 2003), p. 609 (citing W.R. Snodgrass, “Physiological and biochemical differences between children and adults as determinants of toxic response to environmental pollutants,” P.S. Guzelian, C.J. Henry, S.S. Olin, eds. Similarities and Differences Between Children and Adults: Implications for Risk Assessment, (Washington, DC: International Life Sciences Institute Press, 1992), pp. 35-42); and International Labor Organization, Tackling Hazardous Child Labour in Agriculture: Guidance on Policy and Practice, User Guide, 2006,box 5, p. 10.

[170] A study of children under age 18 with acute occupational pesticide-related poisoning from a one-year period found that 47 percent (33 of 70) of ill children in agriculture were exposed through “contact with treated surfaces, most commonly by entering farm fields recently sprayed by pesticides.” Calvert et al, “Acute Pesticide-Related Illnesses Among Working Youths, 1988–1999,” American Journal of Public Health, p. 608.

[171]Walter A. Alarcon et al, “Acute Illnesses Associated with Pesticide Exposures at Schools,” Journal of the American Medical Association, vol. 294, no. 4 (July 27, 2005), pp. 455-465; Center for Worker Health, Wake Forest University School of Medicine, “Policy Brief: Biomarkers of Farmworker Pesticide Exposure in North Carolina,” undated (reporting research results from 2007).

[172] Arcury and Quandt, “Pesticide Exposure Among Farmworkers and Their Families,” Latino Farmworkers in the Eastern United States, Arcury and Quandt, eds., p. 106.

[173]NIOSH, “Pesticide Illness & Injury Surveillance,” April 24, 2009, http://www.cdc.gov/niosh/topics/pesticides/ (accessed January 27, 2010).

[174] Officials in the EPA’s Office of Pesticide Programs told Human Rights Watch that they were unable to estimate farmworkers’ overall pesticide exposure. Human Rights Watch interview with Kevin Keaney and staff of the Office of Pesticide Programs, Environmental Protection Agency, Washington, DC, February 23, 2010. In addition to the barriers farmworkers face in accessing any kind of medical care, poisoned workers who do find care may not be correctly diagnosed, and diagnosed cases may not be reported to surveillance systems. Calvert et al, “Acute Pesticide-Related Illnesses Among Working Youths, 1988–1999,” American Journal of Public Health, p. 609.

[175]Calvert et al, “Acute Pesticide-Related Illnesses Among Working Youths, 1988–1999,” American Journal of Public Health, p. 609.

[176]Michael C.R. Alavanja, Jane A. Hoppin, and Freya Kamel, “Health Effects of Chronic Pesticide Exposure: Cancer and Neurotoxicity,” Annual Review of Public Health, vol. 25 (2004), pp. 155-197; Ana M. Garcia, “Pesticide exposure and women's health,” American Journal of Industrial Medicine, vol. 44 (2003), pp. 584-594; Arcury and Quandt, “Pesticide Exposure Among Farmworkers and Their Families,” Latino Farmworkers in the Eastern United States, Arcury and Quandt, eds., p. 106; and Human Rights Watch telephone interview with Dr. Thomas A. Arcury, Director, Center for Worker Health, Wake Forest University School of Medicine, October 19, 2009.

[177] Human Rights Watch telephone interview with Arcury, Center for Worker Health, Wake Forest University School of Medicine, October 19, 2009.

[178]Alavanja, Hoppin, and Kamel, “Health Effects of Chronic Pesticide Exposure: Cancer and Neurotoxicity,” Annual Review of Public Health, pp. 155-197; Garcia, “Pesticide exposure and women's health, American Journal of Industrial Medicine, pp. 584-594.

[179] Human Rights Watch interview with Raul L., age 21, Durham, North Carolina, August 6, 2009.

[180]Human Rights Watch interview with Julia N., age 18, Benson, North Carolina, August 5, 2009.

[181] Human Rights Watch interview with Luz A., age 18, Plant City, Florida, March 21, 2009.

[182] Human Rights Watch’s interviews are consistent with research in North Carolina finding that “farmworkers generally lack knowledge of the pesticides applied where they work: what is applied, where it is applied, and when it is applied.” Arcury and Quandt, “Pesticide Exposure Among Farmworkers and Their Families,” Latino Farmworkers in the Eastern United States, Arcury and Quandt, eds., p. 116.

[183]Human Rights Watch interview with Alejandro P. (not his real name), age 14, accompanied by his uncle, Benson, North Carolina, August 5, 2009.

[184]Human Rights Watch interview with Julia N., age 18, Benson, North Carolina, August 5, 2009.

[185] Arcury and Quandt, “Pesticide Exposure Among Farmworkers and Their Families,” Latino Farmworkers in the Eastern United States, Arcury and Quandt, eds., p. 119. Gloves made of cloth and leather hold the pesticides to the skin and are also a safety problem. Email from Dr. Thomas A. Arcury, Director, Center for Worker Health, Wake Forest University School of Medicine, to Human Rights Watch, April 8, 2010.

[186]Calvert et al, “Acute Pesticide-Related Illnesses Among Working Youths, 1988–1999,” American Journal of Public Health, p. 608.

[187] For a discussion of this research, see Arcury and Quandt, “Pesticide Exposure Among Farmworkers and Their Families,” Latino Farmworkers in the Eastern United States, Arcury and Quandt, eds., p. 113.

[188] Human Rights Watch interview with Sam B., age 17, Plainview, Texas, July 21, 2009.

[189]Human Rights Watch interview with Alejandro P., age 14, accompanied by his uncle, Benson, North Carolina, August 5, 2009.

[190] Human Rights Watch interview with Mauricio V., age 19, Chapel Hill, North Carolina, August 6, 2009.

[191]Calvert et al, “Acute Pesticide-Related Illnesses Among Working Youths, 1988–1999,” American Journal of Public Health, p. 608.

[192] Officials in the EPA’s Office of Pesticide Programs could not estimate how many workers were untrained because current regulations do not require recordkeeping, but acknowledged “many gaps.” Officials also told us that some workers who had been trained would not necessarily report that they had. Human Rights Watch interview with Keaney and staff of the Office of Pesticide Programs, Environmental Protection Agency, February 23, 2010.

[193] Email from David Strauss, director, Association of Farmworker Opportunity Programs (AFOP), to Human Rights Watch, April 2, 2010.

[194]Human Rights Watch interview with health outreach worker, Benson, North Carolina, August 5, 2009.

[195] Email from Dansereau, Farm Worker Pesticide Project, July 17, 2009.

[196] Human Rights Watch interview with Andrea C., age 17, Saline, Michigan, August 24, 2009.

[197] Human Rights Watch interview with Mauricio V., age 19, Chapel Hill, North Carolina, August 6, 2009.

[198] Human Rights Watch interview with James A., age 15, Plant City, Florida, March 21, 2009.

[199] Human Rights Watch interview with mother, Bear Lake, Michigan, August 27, 2009.

[200] Human Rights Watch interview with Elias N., age 16, Plainview, Texas, July 21, 2009.

[201] Human Rights Watch interview with Elisabeth S., age 19, Durham, North Carolina, August 3, 2009.

[202] Human Rights Watch interview with Marta V., age 13, Plainview, Texas, July 21, 2009.

[203] Human Rights Watch interview with Sam B., age 17, Plainview, Texas, July 21, 2009.

[204] Centers for Disease Control and Prevention, “Heat-Related Deaths Among Crop Workers—United States, 1992-2006,” Morbidity and Mortality Weekly Report, no. 57(24), June 20, 2008, pp. 649-653, http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5724a1.htm (accessed January 25, 2010). The editors note that heat-related deaths were likely underreported.

[205] Valentina Forastieri, Children at Work: Health and Safety Risks (Geneva: ILO, 2002), p. 74; Jeffrey R.  Bytomski and Deborah L. Squire, “Heat Illness in Children,” Current Sports Medicine Reports, vol. 2(6) (2007), p. 320 (noting that children are more susceptible than adults to heat illness because of “greater surface area to body mass ratio, lower rate of sweating, and slower rate of acclimatization”). 

[206] United Farm Workers Union, Deadly Harvest: Heat related deaths of Californian farm workers, (Kreen: United Farm Workers Union, 2009), p. 8. 

[207] Jennie Rodríguez, “Seeking Protection,” Vida En Valle, August 5, 2009; Jennie Rodríguez, “Teen Farmworker's Death Brings Involuntary Manslaughter Charges,” Vida En Valle, May 12, 2009; “Statement from Action Labor and Workforce Development Agency Secretary on Criminal, Civil Charges Filed in Case of Deceased Farm Worker from San Joaquin County,” US Fed News, April 25, 2009.

[208] In contrast, according to the National Agricultural Workers Survey, in 2005-2005, crop workers reported that their employer did not provide, on a daily basis, both drinking water and cups (14 percent), water for washing (3 percent), and a toilet (4 percent). US Department of Labor, “The National Agricultural Workers Survey: Public Access Documentation,” http://www.doleta.gov/agworker/naws.cfm (accessed April 27, 2010).

[209] May, “Occupational Injury and Illness in Farmworkers in the Eastern United States,” Latino Farmworkers in the Eastern United States, Arcury and Quandt, eds., p. 77.

[210] See, for example, Maria L. Ontiveros, “Lessons From the Fields: Female Farmworkers and the Law,” Maine Law Review, vol. 55 (2003), p. 170.

[211] Human Rights Watch interview with Rosa M., mother of two teenage children working in the fields, Plainview, Texas, July 21, 2009.

[212] Arcury and Quandt, “Pesticide Exposure Among Farmworkers and Their Families,” Latino Farmworkers in the Eastern United States, Arcury and Quandt, eds., p. 115.

[213] Human Rights Watch group interview with 15-year-old girl, 10-year old boy, and 9-year-old girl, central Florida, March 22, 2009.

[214] Human Rights Watch interview with Elisabeth S., age 19, Durham, North Carolina, August 3, 2009.

[215] Human Rights Watch group interview with12- and 14-year-old girls, Plainview, Texas, July 20, 2009.

[216] Human Rights Watch group interview with mother, 10 year-old son, and 11-year-old daughter, Plainview, Texas, July 20, 2009.

[217] Human Rights Watch group interview with 12- and 14-year-old girls, Plainview, Texas, July 20, 2009.

[218] Human Rights Watch group interview with mother, 10 year-old son, and 11-year-old daughter, Plainview, Texas, July 20, 2009.

[219] Toilets and handwashing facilities must be “provided for each (20) employees or fraction thereof,” “adequately ventilated, appropriately screened, have self-closing doors that can be closed and latched from the inside and shall be constructed to insure privacy,” “be located within a one-quarter-mile walk of each hand laborer's place of work in the field.” 29 C.F.R. sec. 1928.110(c)(v).

[220] Arcury and Quandt, “Pesticide Exposure Among Farmworkers and Their Families,” Latino Farmworkers in the Eastern United States, Arcury and Quandt, eds., p. 115 (citing 2001 study).

[221] Robert H. McKnight and Henry A. Spiller, “Green Tobacco Sickness in Children and Adolescents,” Public Health Reports, vol. 120 (November-December 2005), http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1497768/?tool=pubmed www.pubmedcentral.nih.gov (accessed January 25, 2010), p. 603.

[222] Ibid.; and Jeffrey S. McBride et al, “Green Tobacco Sickness,” Tobacco Control, vol. 7, (1998), p. 295.

[223] McKnight and Spiller, “Green Tobacco Sickness in Children and Adolescents,” Public Health Reports, p. 603.

[224]Ibid. When “topping,” workers walk through the rows, snapping off the flower from the plant. Harvesting occurs in one of two ways. For flue-cured tobacco, workers snap off individual leaves as they ripen, typically grasping the picked leaves between their arm and chest until they cannot hold anymore. To harvest burley tobacco, workers grasp the stalk of the plant, cut the base, and impale them on a spear to dry in the field, moving them inside only if rains. Ibid.

[225] Ibid. See also Sara A. Quandt et al, “Environmental and Behavioral Predictors of Salivary Cotinine in Latino Tobacco Workers,” Journal of Occupational and Environmental Medicine, vol. 43, no. 10 (2001), pp. 844-52.

[226] Ibid. See also Natalie M. Schmitt et al, “Health Risks in Tobacco Farm Workers—A Review of the Literature,” Journal of Public Health, vol. 15 (2007), p. 263.

[227] Sara Rosenbaum and Peter Shin, Center For Health Services Research and Policy, George Washington University, “Migrant and Seasonal Farmworkers: Health Insurance Coverage and Access to Care,” Kaiser Commission on Medicaid and the Uninsured, April 2005, p. 3; and US Department of Labor, “National Agriculture Workers Survey (Release 3.0),” 2000.

[228] Quandt, “Health of Children and Women in the Farmworker Community in the Eastern United States,” Latino Farmworkers in the Eastern United States, Arcury and Quandt, eds., p. 177 (citing Weathers et al. 2004).

[229] Thomas A. Arcury and Sara A. Quandt, “The Health and Safety of Farmworkers in the Eastern United States: A Need to Focus on Social Justice,” Latino Farmworkers in the Eastern United States, Arcury and Quandt, eds., p. 2; and Rosenbaum and Shin, “Migrant and Seasonal Farmworkers: Health Insurance Coverage and Access to Care,” pp. 1, 3-4; US Department of Labor, “National Agriculture Workers Survey (Release 3.0).” See also National Center for Farmworker Health, Inc. “About America’s Farmworkers: Farmworker Health,” undated, http://www.ncfh.org/?pid=4&page=7 (accessed January 25, 2010).

[230] See Farmworker Justice, “State Workers’ Compensation for Agricultural Workers,” 2009, http://www.fwjustice.org/HealthResources/State%20Workers'%20Comp%20Information%20for%20Health%20Centers.pdf (accessed April 15, 2010).

[231] Human Rights Watch telephone interview with Amy Lieberman, Migrant Clinicians Network, March 6, 2009; National Center for Farmworker Health, Inc., “About Community and Migrant Health Centers,” undated, http://www.ncfh.org/?pid=6 (accessed April 27, 2010).

[232] Rosenbaum and Shin, “Migrant and Seasonal Farmworkers: Health Insurance Coverage and Access to Care.”

[233] May, “Occupational Injury and Illness in Farmworkers in the Eastern United States,” Latino Farmworkers in the Eastern United States, Arcury and Quandt, eds., p. 75.

[234] Migrant Clinicians Network, A Migrant Farmworker Occupational Health Reference Manual, 2006, www.migrantclinician.org/service.dl.php?fid=2121(accessed April 8, 2010)

[235] Human Rights Watch interview with health worker, central Florida, March 23, 2009.

[236] “Willamette Tree Wholesale Sued by EEOC for Severe Sexual Harassment, Retaliation,” US Equal Employment Opportunity Commission press release, June 18, 2009, http://www.eeoc.gov/eeoc/newsroom/release/6-18-09a.cfm (accessed March 19, 2010).

[237] Human Rights Watch telephone interview with Mónica Ramírez, Southern Poverty Law Center, Atlanta, Georgia, December 30, 2009.

[238] Southern Poverty Law Center, “Under Siege: Life for Low-Income Latinos in the South,” p. 28.

[239] William R. Tamayo, “The Role of the EEOC in Protecting the Civil Rights of Farm Workers,” UC Davis Law Review, vol. 22 (Summer, 2000), p. 1080.

[240] Human Rights Watch telephone interview with Maria M., age 19, Idaho, September 13, 2009.

[241] Human Rights Watch interview with Elisabeth S., age 19, Durham, North Carolina, August 3, 2009.

[242]EEOC v. Harris Farms, January 2005, (E.D. Cal.) Civil Action, No. F-02-6199 AWI

[243] Miriam Jordan, “Farmworker Gets Rare Win Against Grower,” The Wall Street Journal, January 24, 2005; and Rebecca Clarren, “The Green Motel,” Ms. Magazine, Summer 2005.

[244] Jordan, “Farmworker Gets Rare Win Against Grower,” The Wall Street Journal; Juliana Barbassa, “Sexually harassed farmworkers often unaware of rights,” Associated Press, October 26, 2005.

[245] Ibid., and “Jury Orders Harris Farms to Pay $994,000 in Sexual Harassment Suit by EEOC,” EEOC press release, January 21, 2005, http://www.eeoc.gov/eeoc/newsroom/release/1-21-05.cfm (accessed March 22, 2010).

[246] Jordan, “Farmworker Gets Rare Win Against Grower,” The Wall Street Journal. Harris Farms appealed, and the Ninth Circuit affirmed the verdict in 2008. “Sexual Harassment Verdict Upheld in Favor of EEOC Against AG Industry Giant Harris Farms,” EEOC press release, April 25, 2008, http://www.eeoc.gov/press/4-25-08.html .

[247] Human Rights Watch telephone interview with William R. Tamayo, EEOC regional attorney, San Francisco, California, July 31, 2009.

[248] Ibid.

[249] Human Rights Watch telephone interview with Maria. M., age 19, Idaho, September 13, 2009.

[250] Email from Mónica Ramírez, Southern Poverty Law Center, to Human Rights Watch April 2, 2010.

[251] Human Rights Watch telephone interview with Maria M., age 19, Idaho, September 13, 2009.

[252] Human Rights Watch telephone interview with Ramírez, Southern Poverty Law Center, December 30, 2009.

[253] Human Rights Watch telephone interview with Tamayo, EEOC, July 31, 2009.

[254]Human Rights Watch telephone interview with Ramírez, Southern Poverty Law Center, December 30, 2009.

[255] Human Rights Watch telephone interview with Tamayo, EEOC, San Francisco, California, July 31, 2009.

[256] Human Rights Watch interview with paralegal and former farmworker, Immokalee, Florida, March 24, 2009.

[257] Sexual harassment and retaliation for complaining about it violate Title VII of Civil Rights Act of 1964. 29 C.F.R. sec. 1604.11.

[258] “Giumarra Vineyards Sued by EEOC for Sexual Harassment and Retaliation Against Farm Workers,” EEOC press release, January 13, 2010, http://www.eeoc.gov/eeoc/newsroom/release/1-13-10.cfm (accessed March 19, 2010) (citing EEOC v. Giumarra Vineyards Corporation et al, January 13, 2010, Civ. No. 5:09-CV-04646-PVT.

[259] The Bandana Project was launched in June 2007 to raise awareness about workplace sexual violence against farmworker women.  More than 2,000 white bandanas have been decorated and displayed as a show of solidarity to end this violence.