Testing the quality of drinking water is essential to protect the public from communicable diseases4
. The purpose of this project was to assess the housing conditions of migrant farmworkers in eastern North Carolina. As part of the assessment the drinking water available to workers in their residences was tested. The Migrant Housing Act of North Carolina § 95–225 (c) Adoption of standards and interpretations outlines that “the Commission for Public Health shall adopt and the Department of Environment and Natural Resources shall enforce rules that establish water quality and water sanitation standards for migrant housing under this Article
”. Providers of the housing are responsible for supplying adequate and sanitary water (North Carolina Migrant Housing Act Article 19 §95–223)18
. Drinking water was tested using the Total Coliform Rule (TCR) monitoring for total coliform and E. coli
. Using the standardized water testing procedure during the growing season, our study found that one-third of residences failed the TCR. Coliform bacteria and E. coli
were detected indicating water contamination with human pathogens. This affects not only farmworkers but also puts the surrounding community consuming water from the same sources at risk.
The literature describing water quality in migrant farmworker camps is sparse9, 11, 12, 13
. Vela-Acosta et al. reported total coliform in 2 out of 5 farmworker camps located in Colorado in 200213
. In 1988 and 1989 Ciesielski et al. found total coliform in 44% and 50% (second year) of 27 and 30 farmworker camps in North Carolina11
. Our study confirms the findings and indicates the persistence of this problem over two decades.
The consequences of consuming contaminated water are dire. In a review of drinking water-associated outbreaks from 1971 to 2006 in the US, over 577,000 persons were affected in 780 outbreaks27
. Most suffered from gastrointestinal illnesses (685 [88%]) such as diarrhea or vomiting, followed by hepatitis A (29 [4%]), and acute respiratory illnesses (24 [3%]) (e.g., legionellosis). There were also rare illness types (15%) ranging from change in hair color to miscarriages. Water samples contained parasites (18%), non-legionella bacteria (14%), chemicals (12%), viruses (8%), legionella (3%), and mixed causes (<1%). However, no cause could be detected in most outbreaks (45%). Unfortunately, information regarding how farmworkers are affected by unsanitary water is very limited. One documented outbreak of typhoid fever occurred in a migrant farmworker camp in Dade County, Florida in 197328
. Two-hundred and forty-six individuals required hospitalization during the outbreak but, fortunately, none died. The water supply system was later identified as the source. The lack of reports does not rule out the existence of outbreaks. Reasons may be small camp sites resulting in low case counts, the often self-limiting character of the diseases, the legal status of farmworkers combined with barriers to access health care, or the non-existence of a public reporting and documentation system for these settings.
Using the data collected during housing assessments, associations between camp site characteristics and water system failures were considered. None showed a significant connection with the water testing outcomes. This is surprising for camps with NCDOL standard certification, and also for registered NTNC public water supply sources. NCDOL standards require water testing before occupancy. However, display of the NCDOL pre-occupancy certification did not ensure sanitary water quality during occupancy. Over two decades ago Ciesielski et al. reported similar findings11
. Only one camp inspected by NCDOL before occupancy was cited for water violations followed by 44% and 50% camp failure rates during the two seasons studied. Receiving water from a NTNC registered source was also expected to provide higher quality water due to more frequent testing and control. However, there was no difference between failure rates of NTNC (7 out of 21) and other water supplies (55 out of 160). Citations for water violations in the NTNC sources further revealed that over 70% of the camps had at least one positive TCR result and one or more monitoring violations (TCR tests not performed) in 2009 and 2010. Only one of the 21 NTNC camps passed the requirements.
Why the two regulatory tools, NCDOL and NTNC standards, failed to protect farmworkers from contaminated water is not fully understood. Two factors may have contributed: timing of testing and enforcement of the rules. Inspecting camps only before occupancy did not ensure water safety. Therefore, testing during the growing season may improve compliance with the standards. For NTNC water supplies, more frequent testing is already part of the regulations. But enforcement appears to be weak allowing providers to ignore water safety breaches or just not test at all. The scale of the penalties should urge providers to choose protection of consumers over indifference. Finding contaminated water in registered public water supply systems may also point toward substantial risks for the general community using similar sources.
There are limitations. The primary goal of this project was to assess the housing characteristics of migrant farmworkers in North Carolina. Interviews of the occupants and extensive sampling of the living spaces and exposure risks from infestation to pesticides were the principal means. However, the water supply set-up was not documented in detail. This leaves open why water systems failed and will require further investigations. The risk of water sample contamination during collection was minimized by following the standardized water collection protocol provided by the state-approved testing laboratories. The repeat samples confirmed previous results rendering contamination unlikely. The cross-sectional design provides a snapshot of the conditions found in the camps in one region over one season. Generalizations of the outcomes to other regions and seasons should be made with caution. However, the high number of recent TCR violations noted in registered NTNC camps over a two year period, and similar results found in an investigation in North Carolina executed two decades ago point to a persistence of these problems11
This study revealed a major breach in housing safety for migrant farmworkers in rural North Carolina. One third of the camp sites investigated failed the TCR indicating a high likelihood of exposure to contaminated drinking water. The risk of physical harm such as diarrhea, vomiting, or acute respiratory illnesses further threatens the already vulnerable population of migrant farmworkers but also residents in adjacent communities using similar water supply systems. Based on a previous assessment in the 1980s and our current findings in a much larger sample, it appears that existing regulations continue to fall short in securing mandated water safety requirements9, 11
. Covering all migrant housing by NCDOL inspections, amending the regulations to water quality testing not only before but also during occupancy and strengthening enforcement of these regulations may be the first steps to improve the water quality of migrant farmworker housing and their surrounding communities.