This project collaborated with Hmong refugee farmers in Washington State to identify and address farm hazards using novel community-based participatory approaches along with conventional industrial hygiene methods, and a systematic assessment of the working conditions and practices of Hmong refugee farmers.
The Hmong are an ethnic group originally from the mountainous regions of southern China and Southeast Asia, who have practiced subsistence agriculture for centuries. According to the U.S. Census, in 2010, nearly 260,000 Hmong refugees were in the U.S., making them one of the largest refugee ethnic groups in the nation. Regionally, a large Hmong farming community resides in western Washington State. Many of these refugees engage in small-scale, family-owned farming. Although Hmong refugees may be skilled in agriculture in their countries of origin, farming in the U.S. poses an unfamiliar environment and practices, which may increase their risk for exposure to agricultural-related hazards, and for resultant injury and illness. This two-year pilot project assessed the work-related safety and health issues among Hmong farmers, using novel, participatory methods to gain insight into the unique challenges this understudied and underserved group encounters.
We began our study by establishing a working relationship with the Hmong community in western Washington State. With the help of the Hmong community liaison, a sample of Hmong men and women farmers were recruited to participate in the assessment over the course of a full growing season. Qualitative data was obtained through discussion groups structured with PRA methods in which workers performed hazard assessment exercises to evaluate information about their own work experiences and their local conditions. Photovoice activities were also used to obtain the perspectives of the participants on what they viewed as health and safety priorities. A “start-of-growing-season” PRA workshop was designed to gain insight into the types of farming activities and tasks, when these tasks are performed throughout the calendar year, the associated safety and health hazards and exposures, and the work practices used to mitigate the risk of injury or illness. Participants most often talked about farm work tasks that put them at risk for musculoskeletal problems. They identified tasks that generally required difficult, awkward postures and positioning, such as bending for long periods, pulling crops out by hand, using tools such as knives to harvest vegetables and flowers, and washing crops.
As an assessment method, employing both the PRA format and Photovoice activities were conducive to directly obtaining participant perspective about what they viewed as safety and health priorities. These approaches complemented with the traditional method of the worksite walk-through inspection, which collectively offered a unique approach that triangulated data sources to gain rich, multi-dimensional perspectives of agricultural safety and health issues. Findings suggest Hmong-operated small-scale farming involves a variety of distinct occupational hazards that would benefit from interventions tailored to context and culture. A Facilitator’s Participatory Rural Appraisal Guide for Occupational Health Professionals was developed to describe the “best practices” that may be transferred and applied to other refugee groups engaging in small operations.
Resources
Neitzel RL, Krenz J, de Castro AB. Safety and health hazard observations in Hmong farming operations. J Agromedicine. 2014;19(2):130-49.
de Castro AB, Krenz J, Neitzel RL. Assessing Hmong farmers' safety and health. Workplace Health Saf. 2014 May;62(5):178-85.
Partners and Advisories
- Washington State University Small Farms Team Project
Principal Investigator: Butch de Castro, PhD, MSN/MPH, RN, FAAN, Professor, Nursing and Environmental and Occupational Health Sciences, University of Washington
NIOSH Funding Period 2011-2013