Consumers may not realize, but someone handpicked every tomato available in the produce section of their local grocery stores. Tomato farming in the United States demands manual labor, long hours, and prolonged exposure to heat and pesticides. Additionally there are psychosocial hazards, including low income, limited legal protections, and racism, that contribute to health inequalities for farmworkers.
Rachel Kelley, a current MD/MS candidate in the UC Berkeley-UCSF Joint Medical Program, looked holistically at the intersection of work and health in the tomato fields for her master's thesis research—from individual-level tasks to company level policy to industry-wide regulations and pressure. In order to translate her research to action, she collaborated with researchers at East Tennessee State University and at the Migrant Clinician Network to produce a tomato workers’ health and safety guide for health care providers.
“This guide is the first of its kind, as far as I know,” says Kelley. “There is a lot of information out there about the hazards of farm work and the poor health of farmworkers in general, but there is much less information that focuses on the work processes and specific hazards involved with harvesting a particular crop.”
The guide draws on published research, experienced health professionals’ advice, and information gathered from interviews and focus groups conducted with 36 tomato workers from diverse backgrounds and 14 community leaders familiar with tomato workers’ health in multiple states.
The first section of the guide focuses on health hazards and health conditions commonly encountered in tomato production. The second section consists of detailed descriptions and illustrations of different tomato production tasks. The third section covers “human resources” information and policies that apply to U.S. agricultural workers generally. Kelley believes the last section also makes the guide special.
“This is important because public policies and psychosocial environments are really the ‘upstream’ factors that shape what hazards workers are exposed to and what resources are available when something goes wrong at work,” she says.
She hopes that the guide will inspire clinicians to build stronger relationships with their patients and help to make agricultural workplaces safer. “Every summer, farmworkers die of heat stress in the fields,” she says. “A clinician may recommend that patients rest in the shade and drink water. But would the conversation be different if the clinician understood that many workers fear they will lose their jobs if they request breaks? Or if the clinician knew there is often no shade in the fields? Armed with this knowledge, the clinician could support efforts to ensure that employers provide sufficient rest breaks and shade to their employees.”
By Jaron Zanerhaft