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Preparing and consuming nutritionally adequate and safe food is critical to the work capacity of migrant farmworkers. This paper: (1) describes observed cooking and eating facilities in migrant farmworker camps, (2) compares observed conditions with existing farmworker housing regulations, and (3) examines associations of violations with camp characteristics.
Data were collected in 182 farmworker camps in eastern NC during the 2010 agricultural season. Observations were compared with 15 kitchen-related housing regulations specified by federal and state housing standards.
Violations of 8 regulations were observed in at least 10% of camps: improper refrigerator temperature (65.5%), cockroach infestation (45.9%), contaminated water (34.4%), rodent infestation (28.9%), improper flooring (25.8%), unsanitary conditions (21.2%), improper fire extinguisher (19.9%), and holes/leaks in walls (12.1%). Logistic regression showed that violations were related to the time of the agricultural season, housing type, number of dwellings and residents, and presence of workers with H-2A visas.
Cooking and eating facilities for migrant farmworkers fail to comply with regulations in a substantial number of camps. Greater enforcement of regulations, particularly post-occupancy during the agricultural season, is needed to protect farmworkers.
Preparing and consuming food is a basic activity of daily living. The ability to consume nutritionally adequate and safe food affects health and the capacity to work. Poor nutrition and reduced work capacity perpetuate the cycle of poverty in economically disadvantaged populations.1 Individuals and households develop nutritional self-management strategies, behavioral patterns involving food preparation, food consumption, and maintaining food security.2 To be adequately nourished, they must be able to execute positive behaviors in all these domains.
The ability of migrant farmworkers to maintain a successful nutritional self-management strategy is constrained by the facilities available to them. They either rent short-term housing on the private market or live in group quarters provided and regulated by their employer. This employer may be a grower or food processor who owns and maintains the housing facilities or a crew leader who rents housing for workers.3,4 Farmworkers may pay to rent housing or receive free housing as part of their employment arrangements. Provision of housing varies regionally. In California, for example, most migrant farmworkers find their own housing,5 while in the Atlantic coast states, growers generally provide housing for migrant workers they employ.6
Migrant housing facilities vary in their size and configuration. Houses, apartments, trailers originally constructed as family housing, or barracks specially built for group quarters are commonly used.7,8 Sanitary conditions of housing vary, and crowding is known to be a common problem. Overall, the few studies of migrant farmworker housing have found the conditions abysmal.4,7,9–15 These aspects of farmworker housing—housing type, sanitation, and crowding—affect the presence, quality and sufficiency of facilities for preparing, storing, and eating food.
Unlike some aspects of housing that may affect comfort or have indirect health effects, those related to cooking and eating carry immediate and significant effects on health, safety, and work capacity.16 An estimated 48 million Americans suffer from food-borne illnesses every year.17 The costs for serious illness and loss of work time add up to $77.7 billion annually in the US alone. Food contamination during storage or preparation, lack of appropriate kitchen facilities and under-cooking can increase the risk of foodborne illnesses.18,19 In the long term, absence of safe food storage or cooking facilities can constrain the type of foods consumed and lead to elevated chronic disease risk.
The number of hired farmworkers in the United States is unknown, but estimates range from 700,000 to 1.4 million.20 These workers are critical to US agricultural production, carrying out much of the cultivation and harvest of fruits and vegetables. The migrant farmworker population includes workers who establish a temporary home in order to do farm work. Some travel in traditional migrant streams, following the crops, while others migrate from point to point, including international migration.21 Migrant farmworkers include both guest workers on special non-immigrant visas (H-2A), as well as workers who may or may not have immigration documents and work directly for a grower or through a crew leader. Previous analyses have shown differences in housing and other health and safety related behaviors between H-2A and non-H-2A workers.8,22–24
Housing in general is recognized as a source of exposures influencing health.25 For migrant farmworkers, housing represents a source of both occupational and environmental exposures.5,8 However, no assessments have specifically focused on the food-related facilities in farmworker housing. The importance of food preparation and food storage is recognized in housing regulations. At the federal level, the Migrant and Seasonal Agricultural Worker Protection Act specifies standards for cooking, kitchens, and mess halls. State regulations must be equal to or exceed these regulations. The analyses presented here use data obtained in a survey of farmworker camps in the context of a community-based participatory research program.3 The aims of this paper are: (1) to describe the observed kitchen facilities and their use in migrant farmworker camps in eastern North Carolina, (2) to compare the observed conditions with existing farmworker housing regulations, and (3) to examine associations of violations with camp characteristics.
This analysis is part of an ongoing program of community-based participatory research that involves investigators at Wake Forest School of Medicine, the North Carolina Farmworkers Project, Student Action with Farmworkers, and other clinics and organizations serving farmworkers in North Carolina. Data were collected from June through October, 2010. This research was approved by the Wake Forest School of Medicine Institutional Review Board.
The research was conducted in a 16 county area of east-central North Carolina where a large number of migrant farmworkers are employed and which are served by four community organizations that collaborated in the research: North Carolina Farmworkers Project, Carolina Family Health Center, Kinston Community Health Center, and Piedmont Health Services.
This research focused on housing in camps occupied by migrant farmworkers. Lists of camps were obtained from the partnering organizations; lists were expanded as new camps were encountered over the course of data collection. All identified camps were contacted to participate. Project field staff traveled to the camp and explained the nature of the study to residents. If camp residents agreed to participate in the study, a camp census was conducted to assess general camp characteristics and to determine eligibility. A total of 186 camps were enrolled in the study. Residents in an additional 36 camps declined to participate, and the grower or contractor refused to permit participation in another four camps. The resulting camp participation rate was 82.3% (186/226). In five of the 186 participating camps, data collection was not completed due to the intervention by the grower. For four of these camps, insufficient information was collected on adherence to kitchen housing regulations; and they could not be included in this analysis. Therefore, the final sample for this analysis included 182 camps. Camps that participated in the study were given a volley ball as a token of appreciation.
Three camp residents were selected in each camp as participants, based on the camp census. Inclusion criteria were being male, currently employed as a farmworker, migrating for employment, and residence in the camp. Two farmworkers were asked to complete an interview questionnaire that included information about use of the kitchen, and the third assisted with the camp inspection. The final sample included 371 men who completed interviews. These farmworkers were each given a $30 cash incentive.
Data for this analysis are based on three components of the research: (1) interviews with two farmworkers in each camp; (2) camp assessments; and (3) assessment of water contamination in the camps. All data collection forms were developed in English and translated into Spanish by a native Spanish speaker familiar with Mexican terminology. The forms were reviewed by staff members of the community partners who were native Spanish speakers. Revised forms were field-tested; the interview questionnaires being pretested with four male migrant farmworkers. All materials were revised based on the field test.
Farmworker interviews were completed by trained staff members who were fluent Spanish speakers. Interviews assessed demographic information, housing features, and perceptions of housing quality. Farmworkers who completed the interviews helped with an assessment of their sleeping rooms. Interviews took approximately 90 minutes to complete.
Housing assessments were completed by trained staff members, who were fluent in Spanish, with the assistance of a farmworker. During the course of the housing assessment, the inspector observed, asked questions, and used aids such as a flashlight and an extending mirror to inspect inside cabinets and behind appliances for signs of pest infestation and exposed wires. To measure refrigerator temperature, a CDN infrared/thermocouple probe thermometer was used. The probe was inserted into refrigerated food such as milk, or the infrared device was used to measure the temperature of a refrigerated food. Measurements were generally taken in the evening. The housing assessment covered multiple areas of the housing, and focused on compliance with standards summarized in the North Carolina Department of Labor (NCDOL) Introduction to Migrant Housing Inspections.26,27 The kitchen/eating area assessment is the focus of the present analyses.
One housing regulation, drinking water safety, was based on laboratory analysis. Water samples were collected according to the guidelines laid out by the Public Water Supply Section of the NC Department of Environment and Natural Resources.28 The water samples were delivered to state-certified laboratories within 24 hours, where the samples were tested for total coliforms and Escherichia coli following standard method 9223.29 The laboratories used a selective and differential medium for the determination of the presence or absence of total coliforms and E. coli in drinking water based on enzyme activity. Quality control procedures consisted of a total of 23 duplicates (12.6% of the entire sample) collected across the four data collection regions. Duplicate samples were collected at the same time as the actual samples, and then a special ID was created to blind the laboratory. All duplicate samples had the same result.
The outcome measures for this analysis were fifteen regulations related to kitchens and eating derived from the NCDOL publications concerning migrant housing inspections (NCDOL 2008a, 2008b). These included regulations related to dwelling structure (n=2), lighting and wiring (n=2), water supply (n=3), kitchen equipment (n=5), sanitation (n=1), and pests (n=2). Except where indicated, assessment recorded presence or absence. For dwelling structure, holes in the walls of the kitchen or eating area and evidence of rain leaks were assessed as a single item; the presence of either was considered a violation. Flooring was assessed in terms of improper flooring material (anything other than wood, asphalt or concrete) and being in poor repair (having holes or open cracks); the presence of either deficiency was considered a violation. Lighting was rated as being a violation if there was no ceiling light fixture in the kitchen. A second lighting violation was noted if there were no convenience electrical outlets (e.g., those not located behind appliances). Water supply violations included lack of hot water in the kitchen, lack of cold water in the kitchen, and coliform contamination of water from the kitchen tap. Kitchen equipment violations were: lack of a refrigerator, refrigerator temperature >45° F in any refrigerator, lack of a stove, lack of a kitchen table, and lack of a fire extinguisher with the proper rating. A violation was noted if food preparation or eating facilities were judged unsanitary. NCDOL regulations do not provide guidance in judging whether or not facilities are sanitary. Therefore, study inspectors judged facilities to be unsanitary if trash and debris accumulations overflowed trash disposal containers or were visible in places other than disposal containers, or if surfaces, equipment (stove and refrigerator), or storage spaces showed evidence of dirt accumulations from cooking or other activities. Finally, two measures of pests were noted: infestation with cockroaches and with rodents.
Camp characteristics and kitchen violations were summarized using frequencies and percentages. Bivariate associations between camp characteristics and each kitchen violation were assessed with chi-square tests or Fisher’s exact tests when necessary. Kitchen violations with sufficient number of events were further modeled using logistic regressions. Odds ratios (OR) and 95% confidence intervals (CI) were presented. All statistical analyses were performed using SAS 9.2 (Cary, NC). A p-value of less than 0.05 was considered statistically significant.
The mean (standard deviation) age of the workers interviewed was 32.8 years (10.4), and the median education was 9 years. Most (95.2%) were from Mexico, and over half (65.2%) came on H-2A visas. Over a third (35.0%) were in their third season or less of work in US agriculture.
Slightly over half (52.0%) reported that they cooked daily in the kitchen; 20.2% cooked several times per week. One in five (21.6%) reported that they rarely or never cooked. Reasons for not cooking daily included taking turns with other workers (23.5%), having someone else paid to cook (17.8%), purchasing meals (5.5%), not liking to cook (4.1%), lack of time (4.1%), or having a significant other or other female who cooked (3.0%). Workers could report more than one reason for not cooking daily; 3.55% reported they did not always have access to a kitchen or that were was no kitchen. Insufficient refrigerator storage space was reported by 12.1% of workers interviewed; 12.7% reported insufficient space to store cooking supplies and utensils outside the refrigerator.
Almost one-third (29.7%) of the camps observed consisted of barracks (Table 1). The remaining camps were mixed, including trailers, old houses, and other non-residential buildings converted to housing. The number of workers in residence at a camp ranged from 3 to 80; a half (48.9%) had ten or fewer workers. Most (62.1%) consisted of a single dwelling, though the number of dwellings comprising a camp ranged up to 8. Over two-thirds (68.7%) included residents with H-2A visas. Inspections were spread across the season, with about half (45.1%) occurring during the mid-summer. About a third (34.4%) displayed a NCDOL certificate of inspection.
Eight violations were observed in more than 10% of camps inspected (Table 2). Structural problems indicating failure to protect against the elements were observed in 12.1% of kitchens, and improper and damaged flooring were observed in 25.8%. Coliform bacteria were present in water samples from 34.4% of kitchens. In 65.5% of inspections, at least one refrigerator in a kitchen had a temperature greater than 45° F. In 19.9% of kitchens, fire extinguishers were either absent or did not meet the minimum rating BC, which indicates use for flammable liquids and electrical fire. Food preparation areas were rated as unsanitary in 21.1% of kitchens. Evidence of cockroach and rodent infestation was observed in 45.9% and 28.9% of kitchens, respectively. Few violations were observed for lighting, having adequate hot and cold water, and presence of required kitchen appliances.
Each of the camp characteristics except number of residents was associated in bivariate analyses with at least one kitchen violation at p<.05 or lower (Table 3). The camp characteristics of workers with no H-2A visas, number of dwellings, and data collection period were associated with the greatest number of kitchen violations. Each violation was associated with at least one camp characteristic except for drinking water contamination, which was dropped from subsequent analyses.
In logistic regression models, all camp characteristics were used to simultaneously predict each kitchen violation (Table 4). Holes in walls and rain leaks were 6.90 (OR; 95% CI 1.89, 25.12) times more likely in camps composed of three or more dwellings, compared to one dwelling. Improper or damaged floors were associated with residences housing workers without H-2A visas (0.35; 0.16, 0.79), camps composed of two dwellings (3.58; 1.44, 8.87), non-barracks (0.28; 0.09, 0.90), and camp assessments in mid-summer (1.97; 0.81, 4.78). Improper refrigerator temperature was associated with H-2A workers in residence (2.33; 1.03, 5.24), with barracks (6.33; 1.84, 21.79), with early summer inspections compared to late (0.23; 0.09, 0.62), and with not having an inspection certificate posted (2.41; 1.13, 5.15). Improper fire extinguisher violations were only associated with non-H-2A camp residents (0.37; 0.16, 0.86). Unsanitary kitchen conditions were found in camps inspected in late summer (4.93; 1.59, 15.30) and in those with no inspection certificate posted (3.83; 1.37, 10.66). Cockroach infestation was associated with non-H-2A camps (0.45; 0.22, 0.93) and showed a trend toward camps with higher number of residents and mid- to late summer inspections. None of the housing characteristics were associated with rodent infestation.
Farmworker housing is a potential source of exposures that threaten workers’ health and safety. Inadequate cooking and eating facilities can compromise workers’ ability to obtain the food needed to maintain the strenuous pace of work demanded by farm work. Over 10% of workers are paid piece-rate, by the bucket of produce picked or tobacco barn filled, a payment arrangement more typical of non-H-2A than H-2A workers (Robinson et al. 2011),24 so work capacity is directly related to wages. Although several reports from different parts of the US have noted the generally poor condition of farmworker housing,4,5,8,13,30 none of these reports have highlighted cooking and eating facilities. This investigation provides an in-depth view of this particular area and shows that a substantial number of camps fail to comply with regulations across a broad spectrum of domains: structure, water supply, kitchen equipment, sanitation, and pest infestation.
The conditions observed suggest that farmworkers are at substantial risk from food- and water-borne illnesses. Improper refrigerator temperatures can accelerate the growth of pathogens in food. Temperatures between 40 and 140° F are considered a danger zone, as some bacteria in food can double in number in 20 minutes at these temperatures.31 Refrigerators in farmworker camps are generally shared by residents who work and eat on approximately the same schedules. Housing regulations require a minimum of .75 cubic feet of refrigerator storage per resident, so a large number of workers may be opening, closing, and adding hot leftover food to a refrigerator, all at about the same time. Combined with hot summer temperatures, these conditions make it difficult for refrigerators to cool food properly.
The presence of contamination in tap water in kitchens poses another health threat. Specific analyses relevant to these findings have been published elsewhere.32 Literature documenting enteric disease in farmworkers dates from the 1970s to the present,19,33–37 with both tap water and water in the fields implicated, and suggestions that malfunctioning sewerage systems may play a role in the contamination. Although water in farmworker housing is tested as part of pre-occupancy inspection, a higher level of contamination is likely later in the season when sewerage systems may be overloaded due to camp overcrowding. The data collection for this study may indicate these post-occupancy problems. The federal Migrant and Seasonal Farmworker Protection Act is enforced in North Carolina by the NCDOL, based on the North Carolina Migrant Housing Act. The North Carolina Migrant Housing Act reflects the federal Act, but imposes some more stringent requirements. These regulations require that all migrant farmworker housing be inspected before it is occupied. Post-residency inspections generally occur only in response to complaints for regulatory violations.
The structural, sanitation, and pest infestation problems documented in these kitchens are inter-related. Holes in floors and walls, as well as water leakage attract pests. They make houses difficult to keep clean. Over half of the workers interviewed cooked daily and about another quarter cooked several days per week. Having this number of workers attempting to cook in what are frequently small kitchens (e.g., of trailers) presents a challenge for keeping kitchens clean. Lack of food storage space causes workers to leave out food supplies that could draw pests. Unsanitary kitchen conditions, whatever their root causes, also attract pests and lead to infestations.
Two attributes of the camp inspections stand out as significant for having multiple violations: absence of H-2A visa holders and timing of data collection across the agricultural season. Camps with H-2A visa holders in residence had significantly fewer kitchen and cooking violations for flooring damage, fire extinguishers, and cock roach violations. Because growers employing H-2A visa holders must have their worker housing inspected preoccupancy, favorable conditions are likely to persist during the season. The state of North Carolina has only a limited number of housing inspectors, so non-H-2A camps are more likely to escape inspection and required corrections. Other research has shown that employers of farmworkers with H-2A visas are adhere more to regulations.24,38 They are more likely than employers of non-H-2A workers to provide pesticide safety training and follow pesticide safety regulations and less likely to violate minimum wage regulations. Migrant workers with H-2A visas are the only farmworkers in North Carolina with a union contract (with the Farm Labor Organizing Committee.) Employers of such workers stand to lose access to this work force if they do not adhere to regulations.
Compared to early summer, inspections in mid- and late summer revealed more violations of regulations for unsanitary conditions and cockroach infestations. Mid-summer is the time of highest farmworker employment, so likely the greatest strain on housing resources. It is therefore not surprising that more conditions that violate regulations appear at that time and persist into late summer. These findings suggest that post-occupancy inspections are needed to promote safe kitchen conditions through the agricultural season. NCDOL does not conduct post-occupancy inspections, even in housing that has been cited for repeat violations, unless complaints are received.
These results should be interpreted in light of their limitations. Data were collected in eastern North Carolina, so may not represent conditions elsewhere. Kitchen inspections were conducted only once in each camp, so may not represent conditions at other times of the summer. In about 18% of known camps, inspections could not be conducted due to refusals of growers or workers. It is impossible to know whether those camps have conditions different from those inspected. These analyses do not include health and illness data to directly link the findings to worker health and work capacity.
Nevertheless, the results represent an intensive inspection of a large number of migrant farmworker camps in a defined region. They indicate substantial threats to health and safety of migrant workers posed by the kitchen and cooking conditions. Further research should be conducted to assess the health effects of these violations. Avenues to greater frequency of inspections should be explored, particularly post-occupancy inspections that can assess adherence to regulations during the agricultural season.
Grant sponsor: National Institute of Environmental Health Sciences
Grant number: R01-ES012358