Occupational heat illness among Latino farmworkers in North Carolina

Background: Symptoms of occupational heat illness provide an early warning that workers are in dangerous environmental conditions. We conducted this analysis to assess the extent to which changes to farmworkers' work activities and behaviors during hot weather were associated with heat illness. Methods: Between June and September 2009, 300 Latino farmworkers participated in an observational study about farmworker health. Participants reported whether they worked in hot weather, made changes to their work activities and behaviors, and experienced symptoms of heat illness during their work in agriculture in the United States. Among workers who reported working in hot weather, we assessed associations between changes in work hours and activities, drinking more water, resting in shaded areas, and going to air-conditioned places during or after work and the prevalence of heat illness. Results: Working in hot weather was reported by 281 (94%) respondents, among whom 112 (40%) reported heat illness. Changing work hours and activities was associated with a lower prevalence of heat illness among H-2A guest workers (prevalence ratio (PR): 0.44; 95% confidence interval (CI): 0.22, 0.89), but not among non H-2A workers (PR: 1.11; 95% CI: 0.79, 1.55). Conclusions: Our findings suggest the need to improve our understanding of working conditions for H-2A and non H-2A workers and assess strategies to reduce agricultural workers' exposure to hot weather.