Health status among farm workers in the Western Cape--collateral evidence from a study of occupational hazards

Farm workers are a marginalised occupational group whose poor living and working conditions may place them at increased risk for occupational and non-occupational morbidity and mortality. Research into the health status of farm workers has been neglected in the past.

As part of an investigation into the neurological and neurobehavioural effects of exposure to organophosphate insecticides, this study describes the demographics, life histories, risk factors for chronic illness and selected indicators of general health status among a group of farm workers in the Western Cape.

Cross-sectional study conducted in the deciduous fruit farming industry in 1993.

164 pesticide applicators and 83 non-spraying controls (all men) from 73 farms, frequency matched for age and education.

A structured questionnaire, venous blood sample for serum and erythrocyte cholinesterase, albumin, gamma glutamyl transferase and haemoglobin assessment, height and weight measurement.

Most farm workers were children of farm workers and had lived and worked on farms for most of their lives. The study found substantial levels of illiteracy (21-44%, depending on the definition) and innumeracy (4%) and evidence of a significant morbidity burden: high levels of alcohol intake and ongoing reported application of the 'dop' system, high levels of head injury (70% of subjects) and evidence of substantial adult undernutrition. Protective equipment was relatively well distributed and used, although certain work activities (such as acting as a human marker) continue to pose substantial exposure hazards. There were no differences in respect of cholinesterase levels between spray applicators and controls, although past poisoning was reported by 9% of subjects.

Farm workers appear to be a closed community with a high disease burden. Their health needs pose substantial challenges to the public health authorities.