School of Public Health and Community Medicine - University of Washington - Winter 2006

PNASH's Role in Farm Safety | Orchard Injuries |
Home Pesticide Exposures | Heat Stress |
The Next Five Years | For Further Reading

PNASH's Role In Farm Safety
Serving Ag Community Needs
NORA Town Hall
Engaging Middle School Students
Continuing Education
Career Day
People & Places
Student Research Day
The Fine Print


Despite many safety advances, agriculture consistently ranks as one of the most hazardous industries in the United States. The agricultural sector (farming, forestry, and fishing) has an annual fatality rate five times higher than the national workplace average, and illnesses and nonfatal injuries are also common. This issue of Environmental Health News focuses on the work of the Pacific Northwest Agricultural Safety and Health Center (PNASH), the agricultural safety research center for the Northwest.


We've all peeled that little "Washington" sticker from our apples and pears. Washington state is the nation's leading producer of apples, pears, sweet cherries, red raspberries, and lesser-known crops such as hops. But while agriculture adds about $5 billion a year to the state's economy, it also adds a measure of injury and illness.

The cost averages more than $8 million a year in workers' compensation claims in just the tree fruit industry in central Washington--plus untold costs to the workers and their families--according to a study by Associate Professor Matt Keifer 5and graduate student Jon Hofmann.

Johnathan Hofmann picture
Jon Hofmann presents a research poster at the Western Migrant Stream Forum.
Photo by Marcy Harrington.

Their work is part of the Pacific Northwest Agricultural Safety and Health Center (PNASH), housed at the University of Washington, which seeks to identify and reduce dangers to farming families and farmworkers in Washington, Idaho, Oregon, and Alaska.

The theme of the PNASH center is Promoting Safe and Sustainable Agricultural Workplaces and Communities. Our goal is to integrate the health and safety of workers and their families within the concept of sustainable agriculture and to develop a measurement scale for a sustainable agricultural workplace, said center Director Richard Fenske. “In our view, the need for sustainable agricultural workplaces extends beyond the boundaries of the farm, and into the rural communities that are themselves the sustenance of the agricultural economy,” he said. “Thus, our theme encompasses a broad public health view of sustainability and includes the next generation within these communities.”

This winter, the center helped organize three activities linking safety with sustainability in the agricultural communities: NIOSH’s agricultural sector NORA Town Hall in Seattle, the 15th Annual Western Migrant Stream Forum in Portland, and the Governor’s Industrial Safety and Health Conference (Ag Safety Day) in Yakima.

The center is partly funded by NIOSH (the National Institute of Occupational Safety and Health). The federal agency is updating its National Occupational Research Agenda (NORA) and held one of a dozen public meetings—the one focusing on agriculture—in Seattle (see link).

The PNASH center helped plan the Northwest Regional Primary Care Association’s 15th annual Western Migrant Stream Forum and sponsored a research poster reception, facilitated by Keifer, co-director of the center. Presenters were Research Scientist Maria Tchong and students Elizabeth Hom, Diana Ceballos, Jon Hofmann, Julie Postma, and Claudio Osses-Henriquez.

PNASH researchers led several conference sessions: Jennifer Crowe, environmental and occupational health of Yakima valley farmworkers and their families; Kit Galvin, hands-on pesticide safety training using fluorescent tracers; Keifer, integrating occupational and environmental health in primary care; Helen Murphy and Catherine Karr, neurobehavioral risks of children’s exposure to organophosphate pesticides; and Sinang Lee, outreach and health education lessons from Cambodia.

The center helped plan and present the second annual governor’s agricultural safety and health conference, commonly called Ag Safety Day. This educational forum was developed in a partnership between state agencies, employer organizations and others, such as the PNASH center. Ag Safety Day reaches hundreds of employers and workers through a combination of both English and Spanish language sessions. Keifer led the Spanish session and Hofmann the English session on orchard injuries; Tchong led the Spanish session and Galvin the English session on home pesticide exposures; and Murphy talked about heat stress.



The goal of the PNASH center orchard injury project is to reduce occupational injuries among workers in the tree fruit industry. Hofmann and Keifer analyzed six years of workers’ compensation claims for central Washington and interviewed 34 injured workers.

Orchard injuries most commonly involve ladders and tree branches or limbs. Keifer and Hofmann found that almost half of all compensable claims between 1996 and 2001 in that region were ladder-related. Ladder injuries tend to be the most severe and costly reported injuries, with $21.5 million in compensation costs for the six-year period.

The interviews with workers, led by Mary Salazar of the UW Occupational Health Nursing Program, were designed to analyze how the injury occurred, why the worker thought it happened, and how the worker thought the injury might have been prevented.

The research team found that 25% of the injured workers had less than a year’s experience in orchards; 44% of cases took place on the upper third of ladder; 47% of the cases resulted from ladder movement; 27% happened when the worker slipped; and the most common injuries were back injuries and ankle sprains. Several injuries occurred when a picker missed the last rung while coming down a ladder with a full bag of apples. The heavy bag can obscure vision and throw the worker off balance.

Keifer, Hofmann, and Salazar concluded that there is a strong and compelling need for interventions that can reduce the number of ladder-related injuries in orchards. They are working with growers and pickers to develop safer tools and work methods.



Ladders are the most common cause of orchard injuries in Washingotn State.
Photo by PNASH Archives.

Farmworkers who are exposed to pesticides may take residues home to their families. PNASH is seeking practical methods to keep the residue in the orchard, and not transport it home on clothing or boots. Galvin and Tchong described these methods to producers and workers at Ag Safety Day.

Separating work and family laundry may not be practical, they said, because only one-third of farmworkers have washers and dryers in the home. Keeping a plastic box in the trunk of the car for work boots, and changing into sandals for the ride home, may be a more realistic preventive measure.

More than ten years of research by Fenske and his team of PNASH investigators has established that work-to-home exposure pathways (agricultural chemicals moving from the workplace to home through the activities of farmworkers) can expose children, as measured through pesticide metabolites in their urine. Dust samples have been collected from households and vehicles to document the pathway. Community members from the Yakima valley have been trained to teach their neighbors safer practices for leaving the pesticide on the job.



Last year a Yakima man died of heat stroke. This led the Washington state Department of Labor and Industries to propose a heat stress rule and led PNASH to collect firsthand stories for an educational campaign.

Murphy, the center’s director of outreach, wants employers to understand the barriers that prevent workers from drinking enough water on the job. Field observers note that water is generally available on agricultural job sites, but usually in a centralized location. Workers consume their water all at once, as opposed to more gradually drinking at the liter-per-hour rate recommended in hot weather.

Good hydration is key to preventing heat stress and subsequent illness, and is an economic issue for the worker, Murphy said. It takes time and effort to go to the water station, and sometimes supervisors and co-workers don’t support the breaks. Time away from the field can mean lost wages for workers paid by piece rate.

Murphy wants to find out more and educate workers about dehydration, as many people wait until they are thirsty, which can be too late. She has asked affected workers to contact her with their own stories about how they became ill. She can be reached at or 206-616-5906.



group pictures
The PNASH contingent at Ag Safety Day (l to r): Jon Hofmann, Marcy Harrington, Matt Keifer, Maria Negrete, Helen Murphy, Richard Fenske, Maria Tchong, Kit Galvin, Yasmin Barris.
Photo by Kathy Hall.

On Feb. 15, PNASH, under Principal Investigator Fenske, submitted its competitive renewal application for continuation of the center for 2006–2011. Ten projects were proposed spanning research, prevention, and education. Principal investigators include: Janice Camp, Fenske, Peter Johnson, Karr, Keifer, John Scott Meschke, Murphy, Mary Salazar, Christopher Simpson, and Mike Yost from the University of Washington; Elizabeth Cartwright, Idaho State University; and Kent Anger and Diane Rohlman, Oregon Health Sciences University.



Curl CL, Fenske RA, Kissel JC, Shirai JH, Moate TF, Griffith W, Coronado G, Thompson B. Evaluation of take-home organophosphorus pesticide exposure among agricultural workers and their children. Environ Health Perspect 2002 Dec;110(12):A787–792.

PNASH information on heat stress

Salazar MK, Keifer M, Negrete M, Estrada F, Snyder K. Occupational risk among orchard workers: A descriptive study. Fam Community Health 2005 Jul–Sep;28(3): 239–252.

WISHA rule development on heat stress Default.thm?RuleID=402