**3. Occupational health issues: tri-partied perspectives**

Agriculture related health issues has been categorized into eight categories; personal, psychosocial, farm, machinery, chemical, biological, and musculoskeletal [21]. In those categorizations, personal health issues are related to injuries from machinery and farm operations and the risk of those are associated with old age (fall and traumatic injuries), young age (machine operations) and chronic health conditions that impairs mobility. Stress has been noted as a major psychological

**39**

*Occupational Health and Safety Standards of Foreign Seasonal Farm Workers…*

illness and long hours and working alone in an isolated environment with less access to healthcare facilities put this population at increased risk for stress. Farm machinery related injuries are noted as resulting from old equipment and defective protective gear use as well as lack of safety labelling and protective structures on the machines [21]. Chemical and biological exposure related illnesses are primarily due to pesticide exposures and biological exposures are noted as from micro-organisms, viruses, toxins (from biological sources), spores, fungi, and bio-active substances that are a threat to human health [21]. A complete list of health issues of migrant farm workers in North America has been published and includes; musculoskeletal, ocular, dermatologic, psychological and sexual and reproductive health [22]. The author's research group conducted individual interviews using a semistructured interview guide among three groups; FSFWs (sample size of eight), local seasonal farm workers (sample size of four) and farmers (sample size of six), who employed them in the province of Nova Scotia, Canada. This was a hard to reach population and snowball sampling method was used to find participants. Participating FSFWs were from Mexico and Jamaica and language difficulties were facilitated using both Spanish and English interviews. The age range of FSFWs was 33–52 years and the local farm workers were between 25 and 53 olds. The FSFWs all were married, and each have between 1 and 6 children, all of whom are living with their wives in their country of origin. Only 2 female local farmworkers were among the study participants. There were 25 different health conditions mentioned by the workers that can be categorized into two groups: work related physical environment issues such as aallergies, asthma, sun burns, eye irritations, skin conditions and sunstrokes; whereas occupational related Injuries included were; hernia, pain and soreness, slipped disk and tendonitis. Other illnesses noted were appendicitis, arthritis, blood pressure, dental problems, diabetes, encephalitis, flu, heart murmur, stomach cancer and ulcer. No psychological issues were reported, but the discussion eluded of work related stress, loneliness and missing home. The occupational health issues noted by the study participants fall into the categories noted in the literature for all agricultural workers [21] as well as migrant farm workers in

*DOI: http://dx.doi.org/10.5772/intechopen.94056*

Canada and elsewhere [22].

**3.1 Occupational health and safety issues: Workers perspective**

availability of information from different sources are evident.

One of the perspectives that we uncovered in our interview data analysis was health issues emerging from lack of proper personal protective equipment. Besides one video, there were no other instructional detailed information releases on personal protective equipment use that we were able to identify. Personal protective equipment (PPE) to be used in the farms included in a video were: work gloves to prevent cuts, bruises and to protect from animals; hearing protectors to prevent noisy equipment use (more than 85 decibels), eye protectors (safety glasses), hard hats (depending on the type of work), steel toed boots to protect from heavy construction areas, reflective clothing to ensure visibility to protect from stuck by farm machinery, respirators and face masks to protect from pesticide and dust exposures and chemical safe overalls to protect from chemical exposures [23]. The English language instructional video further instructs to use sunscreen to prevent from skin burning, sunglasses and a sun hat. We have no evidence that FSFWs have watched any videos or any other paper-based instructions on this matter. However,

Our scoping review of the documents revealed that three parties are responsible for ensuring these personal safety and health protections from a safety standpoint [23]. FSFWs are responsible to ensure that they obtained necessary training to ensure workplace safety and some places have made the videos, posters and

#### *Occupational Health and Safety Standards of Foreign Seasonal Farm Workers… DOI: http://dx.doi.org/10.5772/intechopen.94056*

illness and long hours and working alone in an isolated environment with less access to healthcare facilities put this population at increased risk for stress. Farm machinery related injuries are noted as resulting from old equipment and defective protective gear use as well as lack of safety labelling and protective structures on the machines [21]. Chemical and biological exposure related illnesses are primarily due to pesticide exposures and biological exposures are noted as from micro-organisms, viruses, toxins (from biological sources), spores, fungi, and bio-active substances that are a threat to human health [21]. A complete list of health issues of migrant farm workers in North America has been published and includes; musculoskeletal, ocular, dermatologic, psychological and sexual and reproductive health [22].

The author's research group conducted individual interviews using a semistructured interview guide among three groups; FSFWs (sample size of eight), local seasonal farm workers (sample size of four) and farmers (sample size of six), who employed them in the province of Nova Scotia, Canada. This was a hard to reach population and snowball sampling method was used to find participants. Participating FSFWs were from Mexico and Jamaica and language difficulties were facilitated using both Spanish and English interviews. The age range of FSFWs was 33–52 years and the local farm workers were between 25 and 53 olds. The FSFWs all were married, and each have between 1 and 6 children, all of whom are living with their wives in their country of origin. Only 2 female local farmworkers were among the study participants. There were 25 different health conditions mentioned by the workers that can be categorized into two groups: work related physical environment issues such as aallergies, asthma, sun burns, eye irritations, skin conditions and sunstrokes; whereas occupational related Injuries included were; hernia, pain and soreness, slipped disk and tendonitis. Other illnesses noted were appendicitis, arthritis, blood pressure, dental problems, diabetes, encephalitis, flu, heart murmur, stomach cancer and ulcer. No psychological issues were reported, but the discussion eluded of work related stress, loneliness and missing home. The occupational health issues noted by the study participants fall into the categories noted in the literature for all agricultural workers [21] as well as migrant farm workers in Canada and elsewhere [22].

## **3.1 Occupational health and safety issues: Workers perspective**

One of the perspectives that we uncovered in our interview data analysis was health issues emerging from lack of proper personal protective equipment. Besides one video, there were no other instructional detailed information releases on personal protective equipment use that we were able to identify. Personal protective equipment (PPE) to be used in the farms included in a video were: work gloves to prevent cuts, bruises and to protect from animals; hearing protectors to prevent noisy equipment use (more than 85 decibels), eye protectors (safety glasses), hard hats (depending on the type of work), steel toed boots to protect from heavy construction areas, reflective clothing to ensure visibility to protect from stuck by farm machinery, respirators and face masks to protect from pesticide and dust exposures and chemical safe overalls to protect from chemical exposures [23]. The English language instructional video further instructs to use sunscreen to prevent from skin burning, sunglasses and a sun hat. We have no evidence that FSFWs have watched any videos or any other paper-based instructions on this matter. However, availability of information from different sources are evident.

Our scoping review of the documents revealed that three parties are responsible for ensuring these personal safety and health protections from a safety standpoint [23]. FSFWs are responsible to ensure that they obtained necessary training to ensure workplace safety and some places have made the videos, posters and

*Occupational Wellbeing*

tasks and refusing to carry out tasks they deem unsafe. Employers (farmers) are responsible for ensuring safety in the workplace by following provincial labour regulations and occupational health and safety guidelines. Third parties are responsible for monitoring the necessary guidelines and policies are followed by the two parties, workers and employers. None of the documents indicated, how the multi-partied responsibilities are imposed, implemented, monitored and assessed to ensure health and safety of FSSFWs. According to the government of Canada, Temporary Foreign workers your rights are protected document stated ""*All workers in Canada have the right to a safe workplace. Canada has laws to protect workers from unsafe working conditions. While some jobs may have more risk than others, no one should feel that the work they are doing is unsafe*." [13]. In reality, the protection of the rights are not facilitated, and the laws of protection are not conveyed. Even when they feel that the work is unsafe, there is no way out of the situation due to the fear of losing their job and denial of rehiring again. The international literature suggests two models of responsibilities related to Occupational Safety and Health of workers: (a) introspective model, the one which directs resources to the worker's need and (b) extrospective model is the one, which ensures safety standards prior to seeing the effect on workers [3, 4]. Given that FSFWs work in hazardous work environments, their risk of occupational injuries is high and the need to follow safety protocols should be made mandatory prior to seeing the need. Therefore, the

The shared responsible model for FSFWs workplace health and safety guidelines lack implementation strategies and therefore the level of outreach is questionable. All documents listed pertinent information about health and safety of FSFWs, the language used in each document was not necessarily targeted towards workers and there are no means to ensure the workers understand about occupational health and safety measures. Since the documents are not written at the level of their comprehension, it is unlikely the workers read them. Our research revealed that eighty-four percent of the English documents were written at a college level or greater and the two contracts that FSFWs workers are required to sign before coming to Canada are written at a college graduate level. Thus, while information and resources exist (although limited), it is questionable as to whether this information is finding its way into the hands of FSFWs. This echoes the findings of an Australian study, whereby the researchers found that there is a significant quantity of occupational health and safety resources that exist in Australia, though this information does not necessarily make it into the hands of workers, thus leaving migrant farm workers to rely on word-of-mouth information which may not be reliable [20]. Arguably, the existing health and safety regulations are there for marketing to attract FSFWs and for the purpose of branding the name of the host country in the international labour arena, not necessarily with an intention to keep the workers healthy and safe.

extrospective model would be more appropriate.

**2.2 Health and safety information dissemination**

**3. Occupational health issues: tri-partied perspectives**

Agriculture related health issues has been categorized into eight categories; personal, psychosocial, farm, machinery, chemical, biological, and musculoskeletal [21]. In those categorizations, personal health issues are related to injuries from machinery and farm operations and the risk of those are associated with old age (fall and traumatic injuries), young age (machine operations) and chronic health conditions that impairs mobility. Stress has been noted as a major psychological

**38**

#### *Occupational Wellbeing*

pamphlets available. Most of the information stand as optics to satisfy the government labour regulations but there are no assurance or mechanisms to ensure the information is actually reaching out to workers. The government of Canada seasonal agricultural worker program contract indicates that it is the responsibility of the worker to refuse to work in areas that deem unsafe. Employers are responsible for ensuring workplace safety and to follow labour regulations in their jurisdiction [12]. Our interview findings uncovered the reality.

According to one FSFW:

*"And when I first got there, it was like in early May. I remember it was still really cold in Nova Scotia in May. Like it was often rainy and below like 12 degrees, so like everyone's hands were numb and there was no, no like [to protect my hands]. I sort of got the initial vibe of like toughen up, but like I have really bad blood circulation and like I just didn't have that problem in British Columbia [one of the warm weather provinces], because the temperature was just never that low where we were working."*

The above explanation indicates the status of protective equipment use. Even basic winter gloves to protect from frostbites were not used. One may argue that it is up to the worker to use them but if the use of protective equipment was made mandatory and monitored, the bad blood circulation would have been avoided. Another aspect that emerged from above statement was the intention of avoidance of PPE use was to be "*toughen up*", making themselves strong to the extent to make adaptation to cope up with the environment. Additional Personal protective equipment use was seen by workers as "*getting in the way*" to carry out the assigned tasks quickly. There were also incidents of knowing the need to use PPE, but without proper inspection from the authority or appropriate guard, they miss PPE use and then become prone to serious injuries. One participant explained an injury occurred in a corn field.

According to him; "*Yeah llike when I work in the corn field, we have goggles, we always have glasses on*. *One day I did not have glasses and a leaf probably whacked me in the eye when I was walking through the corn. It was bad and I had to go to the doctor and take time off."*

This clearly indicates that this shared responsibility of PPE use was not implemented appropriately.

Participants reported exacerbation of existing chronic conditions, such as high blood pressure, diabetes and ulcer, but the doctors were attempting to use disease management using a life style change approach. This was something FSFWs noted as distinct from their country. They are used to getting treatment even for slightly elevated blood pressure and ulcers. They indicated that:

*"Every day if I go to a doctor, doctor in Jamaica say, I must be sick, can't take it anymore, if I do not have blood pressure medication and my doctor will give me pills. So when I come up here and if I go to doctor here, if I don't have medication that I took from Jamaica there, they won't give me [prescriptions]. There [in Jamaica] for example there in there put in machine and my hand there and the blood pressure is saying one forty they give me pills. Here [in Canada] they say it is not too high."*

The author's research revealed undesirable work and living environments. They indicted that "*Working here is different from home. Even if it is raining you still have to work. Working seven days a week in rainfall and sunshine. Sun gets really, really hot you still have to be out there*." However, according to the FSFWs' contract, employers are

**41**

As one worker said:

*Occupational Health and Safety Standards of Foreign Seasonal Farm Workers…*

supposed to provide suitable accommodation and workers have the right to refuse the work deem unsafe [12]. The poor conditions of bunk house they live lead to exacerbation of asthma and respiratory conditions. As one FSFW noted:

*"Conditions in bunkhouses were generally poor and often overcrowded....you get put in a house, and that was disgusting, cause that's not how we live in our country. Oh my god. Musty smelling. Like dogs, smells awful. Two to three guys in a little* 

Occupational health issues are not limited to lack of PPE use and unhealthy work environments. Participants reported ergonomic conditions associated with repetitive and overuse of hands and knee problems for standing up for too long, back problems after being in the bending down posture for too long. Literature indicates the most prevalent exposure was related to repetitive movements and resulting illnesses that varied from carpel tunnel syndrome, knee, neck and shoulder issues and back problems due to spending prolong periods of bending down [22]. A study conducted in Ontario, Canada in 2003 interviewed Mexican and Caribbean workers, in their country after returning from Canada and they have indicated that they received proper training to handle machinery and chemicals but they were not given necessary protective equipment to wear [24]. As our study participants revealed those participants also expressed fear of reprisals if they report to authorities. One in five workers they interviewed reported ailments or injuries including vertebrae and knee problems, skin diseases, respiratory tract infections, hypertension, allergies and depression was reported among older workers [24]. Those

*room, single beds. You got at least six or eight men in the bunkhouse."*

conditions were similar to problems noted by our study participants.

*before I can get down to see this gentleman."*

practical solutions to help patients falls into the realm of neglect.

Irrespective of stipulated work hours in the contract seasonal workers chose to work long hours, as long as 9–12 hours a day, for 6–7 days a week and inevitably they became prone to repetitive injuries and posture related ergonomic health conditions. Our study participants added knee problems resulting from standing up for 9–10 hours a day for 6–7 days a week. Attending primary care physician ordered tests and a specialist appointment was given after 8 months of the date of daignosis.

*"Uh, da da da, they wanted to do a scope, last time I was talking to them and I need to wait to get down to a certain specialist in [name of town]. So I think that would've been back in January now. And they said it could be 8 months to a year* 

Given that the FSFWs are in the host country for 8 months only, leaving him to see the specialist is not realistic. One study participant indicated that he had to continue working, limping and no other treatment like physiotherapy nor aids such as knee pads were offered. This neglect of FSFW's work related injuries were common issue that some of the other study participants also revealed. This brings another dimension; racism, discrimination and neglect faced by FSFWs in accessing healthcare and offering solutions that are impractical while ignoring quick fix

Mental or emotional health issues were not reported among our study participants but expressions like "*missing home*" and "*home is a paradise*" were always mentioned. Our participants' conversations spring from missing home, family and independent lifestyles that they had in their country of origin. They often mentioned they are "*living for home*" or "*working for home*" and the living conditions, long hours and missing their family do not matter much. A study conducted among Mexican FSFWs to Canada indicated their expressions of anxiety and/

*DOI: http://dx.doi.org/10.5772/intechopen.94056*

*Occupational Health and Safety Standards of Foreign Seasonal Farm Workers… DOI: http://dx.doi.org/10.5772/intechopen.94056*

supposed to provide suitable accommodation and workers have the right to refuse the work deem unsafe [12]. The poor conditions of bunk house they live lead to exacerbation of asthma and respiratory conditions. As one FSFW noted:

*"Conditions in bunkhouses were generally poor and often overcrowded....you get put in a house, and that was disgusting, cause that's not how we live in our country. Oh my god. Musty smelling. Like dogs, smells awful. Two to three guys in a little room, single beds. You got at least six or eight men in the bunkhouse."*

Occupational health issues are not limited to lack of PPE use and unhealthy work environments. Participants reported ergonomic conditions associated with repetitive and overuse of hands and knee problems for standing up for too long, back problems after being in the bending down posture for too long. Literature indicates the most prevalent exposure was related to repetitive movements and resulting illnesses that varied from carpel tunnel syndrome, knee, neck and shoulder issues and back problems due to spending prolong periods of bending down [22]. A study conducted in Ontario, Canada in 2003 interviewed Mexican and Caribbean workers, in their country after returning from Canada and they have indicated that they received proper training to handle machinery and chemicals but they were not given necessary protective equipment to wear [24]. As our study participants revealed those participants also expressed fear of reprisals if they report to authorities. One in five workers they interviewed reported ailments or injuries including vertebrae and knee problems, skin diseases, respiratory tract infections, hypertension, allergies and depression was reported among older workers [24]. Those conditions were similar to problems noted by our study participants.

Irrespective of stipulated work hours in the contract seasonal workers chose to work long hours, as long as 9–12 hours a day, for 6–7 days a week and inevitably they became prone to repetitive injuries and posture related ergonomic health conditions. Our study participants added knee problems resulting from standing up for 9–10 hours a day for 6–7 days a week. Attending primary care physician ordered tests and a specialist appointment was given after 8 months of the date of daignosis. As one worker said:

*"Uh, da da da, they wanted to do a scope, last time I was talking to them and I need to wait to get down to a certain specialist in [name of town]. So I think that would've been back in January now. And they said it could be 8 months to a year before I can get down to see this gentleman."*

Given that the FSFWs are in the host country for 8 months only, leaving him to see the specialist is not realistic. One study participant indicated that he had to continue working, limping and no other treatment like physiotherapy nor aids such as knee pads were offered. This neglect of FSFW's work related injuries were common issue that some of the other study participants also revealed. This brings another dimension; racism, discrimination and neglect faced by FSFWs in accessing healthcare and offering solutions that are impractical while ignoring quick fix practical solutions to help patients falls into the realm of neglect.

Mental or emotional health issues were not reported among our study participants but expressions like "*missing home*" and "*home is a paradise*" were always mentioned. Our participants' conversations spring from missing home, family and independent lifestyles that they had in their country of origin. They often mentioned they are "*living for home*" or "*working for home*" and the living conditions, long hours and missing their family do not matter much. A study conducted among Mexican FSFWs to Canada indicated their expressions of anxiety and/

*Occupational Wellbeing*

pamphlets available. Most of the information stand as optics to satisfy the government labour regulations but there are no assurance or mechanisms to ensure the information is actually reaching out to workers. The government of Canada seasonal agricultural worker program contract indicates that it is the responsibility of the worker to refuse to work in areas that deem unsafe. Employers are responsible for ensuring workplace safety and to follow labour regulations in their jurisdiction

*"And when I first got there, it was like in early May. I remember it was still really cold in Nova Scotia in May. Like it was often rainy and below like 12 degrees, so like everyone's hands were numb and there was no, no like [to protect my hands]. I sort of got the initial vibe of like toughen up, but like I have really bad blood circulation and like I just didn't have that problem in British Columbia [one of the warm weather provinces], because the temperature was just never that low where* 

The above explanation indicates the status of protective equipment use. Even basic winter gloves to protect from frostbites were not used. One may argue that it is up to the worker to use them but if the use of protective equipment was made mandatory and monitored, the bad blood circulation would have been avoided. Another aspect that emerged from above statement was the intention of avoidance of PPE use was to be "*toughen up*", making themselves strong to the extent to make adaptation to cope up with the environment. Additional Personal protective equipment use was seen by workers as "*getting in the way*" to carry out the assigned tasks quickly. There were also incidents of knowing the need to use PPE, but without proper inspection from the authority or appropriate guard, they miss PPE use and then become prone to serious injuries. One participant explained an injury occurred

According to him; "*Yeah llike when I work in the corn field, we have goggles, we always have glasses on*. *One day I did not have glasses and a leaf probably whacked me in the eye when I was walking through the corn. It was bad and I had to go to the doctor* 

This clearly indicates that this shared responsibility of PPE use was not imple-

Participants reported exacerbation of existing chronic conditions, such as high blood pressure, diabetes and ulcer, but the doctors were attempting to use disease management using a life style change approach. This was something FSFWs noted as distinct from their country. They are used to getting treatment even for slightly

*"Every day if I go to a doctor, doctor in Jamaica say, I must be sick, can't take it anymore, if I do not have blood pressure medication and my doctor will give me pills. So when I come up here and if I go to doctor here, if I don't have medication that I took from Jamaica there, they won't give me [prescriptions]. There [in Jamaica] for example there in there put in machine and my hand there and the blood pressure is saying one forty they give me pills. Here [in Canada] they say it is* 

The author's research revealed undesirable work and living environments. They indicted that "*Working here is different from home. Even if it is raining you still have to work. Working seven days a week in rainfall and sunshine. Sun gets really, really hot you still have to be out there*." However, according to the FSFWs' contract, employers are

elevated blood pressure and ulcers. They indicated that:

[12]. Our interview findings uncovered the reality.

According to one FSFW:

*we were working."*

in a corn field.

*and take time off."*

mented appropriately.

*not too high."*

**40**

or mood disorders as "nerves" without medicalizing into a disease category [22]. Those research particiapnts explanation of feelings of missing home and loneliness is similar that we have observed among our study participants. When considering occupational health of FSFWs it is vital to pay attention to the symptoms of mental and emotional health without labelling since these conditions go undiagnosed or the workers try to hide to show them as able bodied or try to be "toughen up". There was a case of a memory loss of one of his bunk mates as reported by a study participant, presumably, due to an accident of hard object hitting his head or encephalitis. Wearing helmets was a foreign concept for these workers. He noted that his coworkers stayed in the hospital for a month and when he returned, he was unable to remember, where he was and what his friends' names were. The employer sent the worker home (back to the country of origin) upon returning from hospital. This type of injuries can be considered as permanent damages with lifelong disabilities and impairments. Apparently, the practice of sending the workers, who are ill and unable to carry out the work as per contract, called medical repatriation is a common practice and a study conducted in Ontario found there were 4.62% respirations due to medical reasons. Of those 41.3% were surgical related and 25.5% external injuries including poisoning reported during the study period 2001–2011 [25].
