A Multi-Level Approach to Heat Related Illness Prevention in Agricultural Workers

Building on our previous heat-related illness (HRI) studies, we will develop and evaluate a multi-level approach to address HRI for farmworkers in the tree fruit industry. The project will assess a proposed work-based intervention program as well as whether off-hour environmental conditions contribute to risk for HRI during work. To accomplish study aims, an Expert Working Group (EWG), that includes workers, farm managers, and other stakeholders will guide the development, testing, and dissemination of the intervention.

This project proposes to develop and evaluate a multi-level approach to heat-related illness (HRI) prevention in agricultural workers.  Outdoor agricultural workers are at high risk for occupational HRI, and previous studies suggest that HRI risk factors exist at individual, workplace, and community levels, including in hot housing conditions.  The proposed study will build upon the PI's previous HRI work with Washington (WA) tree fruit growers and farmworkers, who are largely foreign-born and Spanish-speaking, to develop an approach to prevention guided by a multi-level model to address these factors within and outside the worksite.

An advisory group that includes workers, farm managers, and other stakeholders will be established to guide the development, testing, and dissemination of the intervention. The intervention, based on the PI's previous research findings, will develop a participatory worker HRI education to address risk factors at individual, workplace, and community levels. Tailored recommendations for growers on how to reduce HRI risk on hot workdays will be developed using Washington State University’s AgWeatherNet weather station network. Heat health effects will be measured using wireless core body temperature sensors to assess worker heat strain and novel mobile text messaging methods or tracking specific heat strain/HRI symptoms.  To address NIOSH’s r2p mission, a final consensus lay document with recommendations for multi-level HRI risk factor assessment and intervention development will be crafted, with input from advisory groups, and disseminated to workers, growers, housing and healthcare stakeholders, scientists, and public health practitioners.  The ultimate goal of this work is to reduce occupational HRI rates in agricultural workers.


Principal Investigator: June Spector, MD, MPH
Associate Professor, Environmental and Occupational Health Sciences
University of Washington|

NIOSH 2016-2021


Specific Aims

Aim 1. Develop, with input from stakeholders, an HRI prevention intervention approach that addresses HRI risk factors at multiple levels.

Aim 2. Evaluate the intervention on occupational heat strain and HRI symptoms in a parallel, comparison, group intervention study in WA tree fruit workers during the summer season. 

Aim 3. Assess whether hot evening farmworker housing conditions worsen health effects of workplace heat stress in these workers using a longitudinal observational study design.

Partnerships and Advisories
Washington State University, AgWeatherNet Program

UW Newsletter: Gabino Abarca: Bridging the Gap Between Research and Agricultural Work


Heat, Exposure, Injury Risk, and Productivity in Agricultural Workers

Pilot: Study of Risk Factors for Health-Related Illness in Agricultural Workers