Cooking and Eating Facilities in Migrant Farmworker Housing in North Carolina

Abstract

Objectives. We sought to (1) describe observed cooking and eating facilities in migrant farmworker camps, (2) compare observed conditions with existing farmworker housing regulations, and (3) examine associations of violations with camp characteristics.

Methods. We collected data in 182 farmworker camps in eastern North Carolina during the 2010 agricultural season. We compared our observations with 15 kitchen-related housing regulations specified by federal and state housing standards.

Results. We observed violations of 8 regulations in at least 10% of camps: improper refrigerator temperature (65.5%), cockroach infestation (45.9%), contaminated water (34.4%), rodent infestation (28.9%), improper flooring (25.8%), unsanitary conditions (21.2%), improper fire extinguisher (19.9%), and holes or leaks in walls (12.1%). Logistic regression showed that violations were related to the time of the agricultural season, housing type, number of dwellings and residents, and presence of workers with H-2A visas.

Conclusions. Cooking and eating facilities for migrant farmworkers fail to comply with regulations in a substantial number of camps. Greater enforcement of regulations, particularly during occupancy during the agricultural season, is needed to protect farmworkers.

Preparing and consuming food is a basic activity of daily living. The ability to consume nutritionally adequate and safe food affects health and the capacity to work. Poor nutrition and reduced work capacity perpetuate the cycle of poverty in economically disadvantaged populations.¹ Individuals and households develop nutritional self-management strategies, behavioral patterns involving food preparation, food consumption, and maintaining food security.² To be adequately nourished, they must be able to execute positive behaviors in all these domains.

The ability of migrant farmworkers to maintain a successful nutritional self-management strategy is constrained by the facilities available to them. They either rent short-term housing on the private market or live in group quarters provided and regulated by their employer. This employer may be a grower or food processor who owns and maintains the housing facilities or a crew leader who rents housing for workers.^3,4 Farmworkers may pay to rent housing or receive free housing as part of their employment arrangements. Provision of housing varies regionally. In California, for example, most migrant farmworkers find their own housing,⁵ whereas in the Atlantic coast states, growers generally provide housing for migrant workers they employ.⁶

Migrant housing facilities vary in their size and configuration. Houses, apartments, and trailers originally constructed as family housing, or barracks specially built for group quarters are commonly used.^7,8 Sanitary conditions of housing vary, and crowding is known to be a common problem. Overall, the few studies of migrant farmworker housing have found the conditions to be poor.^4,7,9–15 These aspects of farmworker housing—housing type, sanitation, and crowding—affect the presence, quality, and sufficiency of facilities for preparing, storing, and eating food.

Unlike some aspects of housing that may affect comfort or have indirect health effects, those related to cooking and eating carry immediate and significant effects on health, safety, and work capacity.¹⁶ An estimated 48 million Americans suffer from foodborne illnesses every year.¹⁷ The costs for serious illness and loss of work time add up to $77.7 billion annually in the United States alone. Food contamination during storage or preparation, lack of appropriate kitchen facilities, and undercooking can increase the risk of foodborne illnesses.^18,19 In the long term, absence of safe food storage or cooking facilities can constrain the type of foods consumed and lead to elevated chronic disease risk. For example, the inability to safely store fresh fruits and vegetables can lead to low consumption, a known risk factor for diabetes and cancer.²⁰

The number of hired farmworkers in the United States is unknown, but estimates range from 700 000 to 1.4 million.²¹ These workers are critical to US agricultural production, carrying out much of the cultivation and harvest of fruits and vegetables. The migrant farmworker population includes workers who establish a temporary home to do farm work. Some travel in traditional migrant streams, following the crops, whereas others migrate from point to point, including international migration.²² Nationally, three quarters of migrant workers report being born in Mexico, with most of the remainder being born in the United States.²² Migrant farmworkers include guest workers on special nonimmigrant visas (H-2A), as well as workers who may or may not have immigration documents and work directly for a grower or through a crew leader. Previous analyses have shown differences in housing and other health- and safety-related behaviors between H-2A and non–H-2A workers.^8,23–25

Housing in general is recognized as a source of exposures influencing health.²⁶ For migrant farmworkers, housing represents a source of both occupational and environmental exposures.^5,8 However, no assessments have specifically focused on the food-related facilities in farmworker housing. The importance of food preparation and food storage is recognized in housing regulations. At the federal level, the Migrant and Seasonal Agricultural Worker Protection Act specifies standards for cooking, kitchens, and mess halls.²⁷ State regulations must be equal to or exceed these regulations. The analyses presented here use data obtained in a survey of farmworker camps in the context of a community-based participatory research program.³ Our aims were (1) to describe the observed kitchen facilities and their use in migrant farmworker camps in eastern North Carolina, (2) to compare the observed conditions with existing farmworker housing regulations, and (3) to examine associations of violations with camp characteristics.

METHODS

This analysis is part of an ongoing program of community-based participatory research that involves investigators at Wake Forest School of Medicine, the North Carolina Farmworkers Project, Student Action With Farmworkers, and other clinics and organizations serving farmworkers in North Carolina. Data were collected as part of a larger study³ from June through October 2010. Details of methods are available elsewhere.³

Sample

The research was conducted in a 16-county area of east-central North Carolina where a large number of migrant farmworkers are employed and are served by 4 community organizations that collaborated in the research.

This research focused on housing in camps occupied by migrant farmworkers. We expanded camp lists from the partnering organizations as we encountered new camps during data collection. We contacted all identified camps to participate. A total of 186 camps were enrolled in the study. Residents in an additional 36 camps declined to participate, and the grower or contractor refused to permit participation in another 4 camps. The resulting camp participation rate was 82.3% (186 of 226). In 4 of the 186 participating camps, insufficient data collection was completed because of intervention by the grower. Therefore, the final sample for this analysis included 182 camps; 138 were all male and the remainder had at least 1 female worker present. Camps that participated in the study were given a volley-ball as a token of appreciation.

We selected 3 male camp residents in each camp as participants, based on a camp census. We asked 2 farmworkers to complete an interview questionnaire that included information about use of the kitchen, and the third assisted with the camp inspection. The final sample included 371 men who completed interviews and 182 who assisted with the camp inspections; 231 men refused to participate when asked. Participating farmworkers were each given a $30 cash incentive.

Data Collection

Data for this analysis were based on 3 components of the research: (1) interviews with 2 farmworkers in each camp, (2) camp assessments, and (3) assessment of water contamination in the camps. All data collection forms were developed in English and translated into Spanish by a native Spanish speaker familiar with terminology used by Latino farmworkers in North Carolina. Most farmworkers in North Carolina are born in Mexico, with a small percentage from Central America or the United States.²⁸ The community partners who were native Spanish speakers reviewed the forms. We field-tested the revised forms by pretesting the interview questionnaires with 4 male migrant farmworkers. We revised all materials on the basis of the field test.

Trained staff members who were fluent Spanish speakers completed the farmworker interviews. Interviews assessed demographic information and use of kitchen facilities.

Staff members, who were fluent in Spanish, completed the housing assessments with the assistance of a farmworker. Staff training included didactic sessions reviewing regulations and criteria for scoring adherence to regulations, as well as group practice assessments to reach scoring consensus. During the course of the housing assessment, the inspector observed, asked questions, and used aids such as a flashlight and an extending mirror to inspect inside cabinets and behind appliances for signs of pest infestation and exposed wires. The inspector used a CDN infrared/thermocouple probe thermometer (Component Design Northwest Inc, Portland, OR) to measure refrigerator temperature. The probe was inserted into refrigerated food such as milk, or the infrared device was used to measure the temperature of a refrigerated food. Measurements were generally taken in the evening. The housing assessment focused on compliance with standards summarized in the North Carolina Department of Labor (NCDOL) Introduction to Migrant Housing Inspections.²⁹ The kitchen and eating area assessment was the focus of the present analyses.

One housing regulation, drinking water safety, was based on laboratory analysis for total coliforms and Escherichia coli. We describe analysis procedures and quality control elsewhere.³⁰

Measures

The outcome measures for this analysis were 15 regulations related to kitchens and eating derived from the NCDOL publication concerning migrant housing inspections.²⁹ These included regulations related to dwelling structure (n = 2), lighting and wiring (n = 2), water supply (n = 3), kitchen equipment (n = 5), sanitation (n = 1), and pests (n = 2). Except where indicated, assessment recorded presence or absence.

For dwelling structure, we assessed holes in the walls of the kitchen or eating area and evidence of rain leaks as a single item; we considered the presence of either a violation. We assessed flooring in terms of improper flooring material (anything other than wood, asphalt, or concrete) and being in poor repair (having holes or open cracks); the presence of either deficiency was considered a violation. We rated lighting as being a violation if there was no ceiling light fixture in the kitchen. We noted a second lighting violation if there were no convenience electrical outlets (e.g., those not located behind appliances). Water supply violations included lack of hot water in the kitchen, lack of cold water in the kitchen, and coliform contamination of water from the kitchen tap. Kitchen equipment violations were lack of a refrigerator, refrigerator temperature greater than 45° F in any refrigerator, lack of a stove, lack of a kitchen table, and lack of a fire extinguisher with the proper rating. We noted a violation if we judged food preparation or eating facilities unsanitary. The NCDOL regulations do not provide guidance in judging whether facilities are sanitary. Therefore, study inspectors judged facilities to be unsanitary if trash and debris accumulations overflowed trash disposal containers or were visible in places other than disposal containers, or if surfaces, equipment (stove and refrigerator), or storage spaces showed evidence of dirt accumulations from cooking or other activities. The research team took photographs to document conditions. Finally, we noted 2 measures of pests: infestation with cockroaches and with rodents.

Data Analysis

We summarized camp characteristics and kitchen violations by using frequencies and percentages. We assessed bivariate associations between camp characteristics and each kitchen violation with the χ² test or Fisher’s exact test when necessary. We further modeled kitchen violations with sufficient number of events by using logistic regressions, and we presented odds ratios (ORs) and 95% confidence intervals (CIs). We performed all statistical analyses with SAS version 9.2 (SAS Institute, Cary, NC). A P value of less than .05 was considered statistically significant.

RESULTS

The mean age of the workers interviewed was 32.8 years (SD = 10.4), and the median education was 9 years. Most (95.2%) were from Mexico, and more than half (65.2%) came on H-2A visas. More than a third (35.0%) were in their third season or less of work in US agriculture.

Slightly more than half (52.0%) reported that they cooked daily in the kitchen; 20.2% cooked several times per week. One in 5 (21.6%) reported that they rarely or never cooked. Reasons for not cooking daily included taking turns with other workers (23.5%), having someone else paid to cook (17.8%), purchasing meals (5.5%), not liking to cook (4.1%), lack of time (4.1%), or having a significant other or other female who cooked (3.0%). Workers could report more than 1 reason for not cooking daily; 3.55% reported they did not always have access to a kitchen or that there was no kitchen. Insufficient refrigerator storage space was reported by 12.1% of workers interviewed; 12.7% reported insufficient space to store cooking supplies and utensils outside the refrigerator.

Almost one third (29.7%) of the camps observed consisted of barracks (Table 1). The remaining camps were mixed, including trailers, old houses, and other nonresidential buildings converted to housing. The number of workers in residence at a camp ranged from 3 to 80; a half (48.9%) had 10 or fewer workers. Most (62.1%) consisted of a single dwelling, though the number of dwellings comprising a camp ranged up to 8. More than two thirds (68.7%) included residents with H-2A visas. Inspections were spread across the season, with about half (45.1%) occurring during the midsummer. About a third (34.4%) displayed an NCDOL certificate of inspection.

TABLE 1—

Farmworker Camp Characteristics: Eastern North Carolina, 2010

Characteristic	No. (%)
Housing type
Nonbarracks	128 (70.3)
Barracks	54 (29.7)
No. of residents
1–10	89 (48.9)
11–20	47 (25.8)
> 20	46 (25.3)
No. of dwellings
1	113 (62.1)
2	35 (19.2)
≥ 3	34 (18.7)
Visa status of residents
Non–H-2A	57 (31.3)
H-2A	125 (68.7)
Time of inspection
Early summer	51 (28.0)
Midsummer	82 (45.1)
Late summer	49 (26.9)
Certificate of inspection
Posted	62 (34.4)
Not posted	118 (65.6)

Note. The sample size was n = 182. Numbers may not add to 182 because of missing data.

We observed 8 violations of the total of 15 assessed in more than 10% of camps inspected (Table 2). We observed structural problems indicating failure to protect against the elements in 12.1% of kitchens, and improper and damaged flooring in 25.8%. Coliform bacteria were present in water samples from 34.4% of kitchens. In 65.5% of inspections, at least 1 refrigerator in a kitchen had a temperature greater than 45° F. In 19.9% of kitchens, fire extinguishers were either absent or did not meet the minimum rating BC, which indicates use for flammable liquids and electrical fire. Inspectors rated food preparation areas as unsanitary in 21.1% of kitchens. Inspectors observed evidence of cockroach and rodent infestation in 45.9% and 28.9% of kitchens, respectively. We observed few violations for lighting, having adequate hot and cold water, and presence of required kitchen appliances.

TABLE 2—

Violations of Kitchen Housing Regulations in 182 Farmworker Camps: Eastern North Carolina, 2010

Regulationa	Observed Violation	No. (%)
Structure
Structure constructed to provide protection against elements; no holes in floors, walls, or roofs	Holes in wall; evidence of rain leaks	22 (12.1)
Wood, asphalt, or concrete floor; smooth, tight construction, in good repair	Improper flooring material; damaged floor	47 (25.8)
Lighting
≥ 1 ceiling light fixture	No lighting	5 (2.8)
≥ 1 convenience outlet	No electrical outlets	2 (1.1)
Water supply
Adequate and convenient	No hot water	3 (1.7)
	No cold water	2 (1.1)
Approved by health authority	Coliform contamination in drinking water	62 (34.4)
Kitchen equipment
An operable refrigerator	No refrigerator	2 (1.1)
Refrigerator temperature ≤ 45° F	Improper refrigerator temperatureb	116 (65.5)
An operable stove	No stove	1 (0.5)
A table	No table	3 (1.7)
Fire extinguisher with minimum rating of 5 BC	No or improper fire extinguisher rating	35 (19.9)
Food preparation and eating facilities clean and sanitary	Unsanitary kitchen conditions	38 (21.1)
Effective measures to prevent infestation by and harborage of pests	Cockroach infestation	83 (45.9)
	Rodent infestation	52 (28.9)

Note. BC = a rating for extinguishing flammable liquid and electrical fires.

^aRegulation definitions and interpretations derived from North Carolina Department of Labor.²⁹

^bCamps had up to 12 refrigerators. Improper temperature in 1 or more refrigerators was considered a violation.

Each of the camp characteristics except number of residents was associated in bivariate analyses with at least 1 kitchen violation at P < .05 (Table 3). The camp characteristics of workers with no H-2A visas, number of dwellings, and data collection period were associated with the greatest number of kitchen violations. Each violation was associated with at least 1 camp characteristic except for drinking water contamination, which we dropped from subsequent analyses.

TABLE 3—

Bivariate Comparisons of Most Common Kitchen Violations by Migrant Farmworker Camp Characteristics, Eastern North Carolina, 2010

Camp Characteristics	Holes in Wall; Rain Leaks, No. (%)	Damaged Floor, No. (%)	Drinking Water Contamination, No. (%)	Improper Refrigerator Temperature, No. (%)	Improper Fire Extinguisher, No. (%)	Unsanitary Kitchen Conditions, No. (%)	Cockroach Infestation, No. (%)	Rodent Infestation, No. (%)
H-2A visa workers	**	*			*	*	*	*
Present (n = 125)	11 (8.8)	24 (19.2)	38 (30.9)	81 (66.9)	18 (14.9)	20 (16.1)	51 (40.8)	42 (33.6)
Not present (n = 57)	11 (19.3)	23 (40.4)	24 (42.1)	35 (62.5)	17 (30.9)	18 (32.1)	32 (57.1)	10 (18.2)
No. of dwellings	**	**				*
1 (n = 113)	9 (8.0)	21 (18.6)	40 (35.7)	72 (65.6)	24 (21.8)	18 (16.1)	49 (43.4)	37 (33)
2 (n = 35)	3 (8.6)	15 (42.9)	10 (28.6)	18 (52.9)	7 (21.2)	8 (22.9)	16 (45.7)	10 (28.6)
≥ 3 (n = 34)	10 (29.4)	11 (32.4)	12 (36.4)	26 (78.8)	4 (12.1)	12 (36.4)	18 (54.6)	5 (15.2)
Housing type				**
Barracks (n = 54)	8 (14.8)	10 (18.5)	17 (31.5)	42 (84.0)	10 (20.0)	16 (29.6)	27 (50.9)	15 (28.3)
Nonbarracks (n = 128)	14 (10.9)	37 (28.9)	45 (35.7)	74 (58.3)	25 (19.8)	22 (17.5)	56 (43.4)	37 (29.1)
No. of residents
1–10 (n = 89)	10 (11.2)	20 (22.5)	26 (29.6)	50 (56.8)	15 (17.2)	14 (15.9)	45 (50.6)	29 (33.0)
11–20 (n = 47)	5 (10.6)	15 (31.9)	22 (46.8)	35 (76.1)	11 (23.9)	11 (23.9)	17 (36.2)	15 (31.9)
> 20 (n = 46)	7 (15.2)	12 (26.1)	14 (13.1)	31 (72.1)	9 (20.9)	13 (28.3)	21 (46.7)	8 (17.8)
Data collection period		**		**		*
Early summer (n = 51)	6 (11.8)	10 (19.6)	16 (32.0)	40 (81.6)	6 (12.2)	6 (12)	18 (35.3)	12 (24.0)
Midsummer (n = 82)	13 (15.9)	30 (36.6)	28 (34.2)	52 (65.8)	21 (26.6)	15 (18.5)	37 (45.7)	25 (30.9)
Late summer (n = 49)	3 (6.1)	7 (14.3)	18 (37.5)	24 (49.0)	8 (16.7)	17 (34.7)	28 (57.1)	15 (30.6)
Inspection certificate						**
Not posted (n = 118)	17 (14.4)	35 (29.7)	37 (31.9)	78 (69.0)	26 (22.8)	32 (27.6)	57 (48.6)	31 (26.5)
Posted (n = 62)	5 (8.1)	12 (19.4)	23 (37.1)	36 (58.1)	8 (13.3)	6 (9.7)	25 (40.3)	20 (32.8)

*P < .05; **P < .01.

In logistic regression models, we used all camp characteristics to simultaneously predict each kitchen violation (Table 4). Holes in walls and rain leaks were 6.90 (95% CI = 1.89, 25.12) times more likely in camps composed of 3 or more dwellings, compared with 1 dwelling. Improper or damaged floors were associated with residences housing workers without H-2A visas (OR = 0.35; 95% CI = 0.16, 0.79), camps composed of 2 dwellings (OR = 3.58; 95% CI = 1.44, 8.87), nonbarracks (OR = 0.28; 95% CI = 0.09, 0.90), and camp assessments in midsummer (OR = 1.97; 95% CI = 0.81, 4.78). Improper refrigerator temperature was associated with H-2A workers in residence (OR = 2.33; 95% CI = 1.03, 5.24), with barracks (OR = 6.33; 95% CI = 1.84, 21.79), with early summer inspections compared with late (OR = 0.23; 95% CI = 0.09, 0.62), and with not having an inspection certificate posted (OR = 2.41; 95% CI = 1.13, 5.15). Fire extinguisher violations were only associated with non–H-2A camp residents (OR = 0.37; 95% CI = 0.16, 0.86). Unsanitary kitchen conditions were found in camps inspected in late summer (OR = 4.93; 95% CI = 1.59, 15.30) and in those with no inspection certificate posted (OR = 3.83; 95% CI = 1.37, 10.66). Cockroach infestation was associated with non–H-2A camps (OR = 0.45; 95% CI = 0.22, 0.93) and showed a trend toward camps with lower number of residents and mid- to late-summer inspections. None of the housing characteristics were associated with rodent infestation.

TABLE 4—

Logistic Regression Models for Kitchen Violations, Predicted by Migrant Farmworker Camp Characteristics, Eastern North Carolina, 2010

Camp Characteristics	Holes in Wall; Rain Leaks, OR (95% CI)	Damaged Floor, OR (95% CI)	Improper Refrigerator Temperature, OR (95% CI)	Improper Fire Extinguisher, OR (95% CI)	Unsanitary Kitchen Conditions, OR (95% CI)	Cockroach Infestation, OR (95% CI)	Rodent Infestation, OR (95% CI)
Workers with H-2A visas
Present (n = 128)	0.47 (0.17,1.30)	0.35 (0.16, 0.79)	2.33 (1.03, 5.24)	0.37 (0.16, 0.86)	0.57 (0.24, 1.34)	0.45** (0.22, 0.93)	1.86 (0.80, 4.29)
Not present (n = 57; Ref)	1.00	1.00	1.00	1.00	1.00	1.00	1.00
No. of dwellings
1 (n = 113; Ref)	1.00	1.00	1.00	1.00	1.00	1.00	1.00
2 (n = 35)	1.20 (0.29, 4.92)	3.58 (1.44, 8.87)	0.55 (0.23, 1.32)	0.83 (0.30, 2.29)	1.42 (0.51, 3.88)	1.21 (0.54, 2.70)	0.90 (0.38, 2.14)
≥ 3 (n = 34)	6.90 (1.89, 25.12)	2.31 (0.80, 6.67)	1.43 (0.48, 4.24)	0.29 (0.08, 1.09)	2.01 (0.66, 6.11)	2.02 (0.79, 5.17)	0.51 (0.16, 1.58)
Housing type
Barracks (n = 54)	1.13 (0.28, 4.63)	0.28 (0.09, 0.90)	6.33 (1.84, 21.79)	0.94 (0.30, 2.96)	2.07 (0.65, 6.56)	1.90 (0.77, 4.64)	1.87 (0.72, 4.87)
Nonbarracks (n = 128; Ref)	1.00	1.00	1.00	1.00	1.00	1.00	1.00
No. of residents
1–10 (n = 89; Ref)	1.00	1.00	1.00	1.00	1.00	1.00	1.00
11–20 (n = 47)	0.48 (0.13, 1.74)	1.21 (0.48, 3.02)	2.20 (0.89, 5.49)	1.52 (0.58, 4.02)	1.49 (0.53, 4.22)	0.40 (0.18, 0.91)	1.01 (0.44, 2.31)
> 20 (n = 46)	0.35 (0.06, 2.00)	1.55 (0.44, 5.46)	0.66 (0.19, 2.33)	1.50 (0.38, 5.88)	1.06 (0.25, 4.47)	0.33 (0.11, 1.01)	0.39 (0.11, 1.34)
Data collection period
Early summer (n = 51; Ref)	1.00	1.00	1.00	1.00	1.00	1.00	1.00
Midsummer (n = 82)	1.19 (0.39, 3.59)	1.97 (0.81, 4.78)	0.47 (0.19, 1.19)	3.13 (1.04, 9.38)	1.48 (0.50, 4.41)	1.56 (0.72, 3.38)	1.49 (0.63, 3.53)
Late summer (n = 49)	0.38 (0.08, 1.76)	0.58 (0.19, 1.77)	0.23 (0.09, 0.62)	1.98 (0.57, 6.90)	4.93 (1.59, 15.30)	2.58 (1.09, 6.09)	1.44 (0.56, 3.70)
Inspection certificate
Not posted (n = 118)	1.50 (0.49, 4.65)	1.33 (0.58, 3.06)	2.41 (1.13, 5.15)	1.62 (0.64, 4.10)	3.83 (1.37, 10.66)	1.20 (0.61, 2.35)	0.81 (0.39, 1.66)
Posted (n = 62; Ref)	1.00	1.00	1.00	1.00	1.00	1.00	1.00

Note. CI = confidence interval; OR = odds ratio.

**P < .01.

DISCUSSION

Farmworker housing is a potential source of exposures that threaten workers’ health and safety. Inadequate cooking and eating facilities can compromise workers’ ability to obtain the food needed to maintain the strenuous pace of work demanded by farm work. More than 10% of workers are paid piece-rate, by the bucket of produce picked or tobacco barn filled, a payment arrangement more typical of non–H-2A than H-2A workers,²⁵ so work capacity is directly related to wages. Although several reports from different parts of the United States have noted the generally poor condition of farmworker housing^4,5,8,13,31 and some studies have noted significant levels of poverty-linked food insecurity,^32,33 none of these reports have highlighted cooking and eating facilities. This investigation provides an in-depth view of this particular area and shows that a substantial number of camps fail to comply with regulations across a broad spectrum of domains: structure, water supply, kitchen equipment, sanitation, and pest infestation. This is the first study, to our knowledge, to evaluate cooking and eating facilities against established housing regulations.

The conditions observed suggest that farmworkers are at substantial risk from food- and waterborne illnesses and chronic diseases. Improper refrigerator temperatures can accelerate the growth of pathogens in food. Temperatures between 40° F and 140 °F are considered a danger zone, as some bacteria in food can double in number in 20 minutes at these temperatures.³⁴ Refrigerators in farmworker camps are generally shared by residents who work and eat on approximately the same schedules. Housing regulations require a minimum of 0.75 cubic feet of refrigerator storage per resident, so a large number of workers may be opening, closing, and adding hot leftover food to a refrigerator, all at about the same time. Combined with hot summer temperatures, these conditions make it difficult for refrigerators to cool food properly. Lack of adequate refrigeration may also constrain food variety, particularly consumption of fresh fruits and vegetables, a risk factor for numerous chronic diseases.²⁰

The presence of contamination in tap water in kitchens poses another health threat. Specific analyses relevant to these findings have been published elsewhere.³⁰ Literature documenting enteric disease in farmworkers dates from the 1970s to the present,^19,35–39 with both tap water and water in the fields implicated, and suggestions that malfunctioning sewerage systems may play a role in the contamination. Although water in farmworker housing is tested as part of preoccupancy inspection, a higher level of contamination is likely later in the season when sewerage systems may be overloaded because of camp overcrowding. The data collection for this study may indicate these postoccupancy problems. The federal Migrant and Seasonal Farmworker Protection Act is enforced in North Carolina by the NCDOL, based on the North Carolina Migrant Housing Act.^27,40 The North Carolina Migrant Housing Act reflects the federal act, but imposes some more stringent requirements. These regulations require that all migrant farmworker housing be inspected before it is occupied. Postresidency inspections generally occur only in response to complaints for regulatory violations.

The structural, sanitation, and pest infestation problems documented in these kitchens are interrelated. Holes in floors and walls, as well as water leakage, attract pests. They make houses difficult to keep clean. More than half of the workers interviewed cooked daily and about another quarter cooked several days per week. Having this number of workers attempting to cook in what are frequently small kitchens (e.g., of trailers) presents a challenge for keeping kitchens clean. Lack of food storage space causes workers to leave out food supplies that could draw pests. Unsanitary kitchen conditions, whatever their root causes, also attract pests and lead to infestations.

Two attributes of the camp inspections stand out as significant for having multiple violations: absence of H-2A visa holders and timing of data collection across the agricultural season. Camps with H-2A visa holders in residence had significantly fewer kitchen and cooking violations for flooring damage, fire extinguishers, and cockroach violations. Because growers employing H-2A visa holders must have their worker housing inspected before occupancy, favorable conditions are likely to persist during the season. The state of North Carolina has only a limited number of housing inspectors, so non–H-2A camps are more likely to escape inspection and required corrections. Other research has shown that employers of farmworkers with H-2A visas adhere more to regulations.^25,41 They are more likely than employers of non–H-2A workers to provide pesticide safety training and follow pesticide safety regulations and less likely to violate minimum wage regulations. Migrant workers with H-2A visas are the only farmworkers in North Carolina with a union contract (with the Farm Labor Organizing Committee). Employers of such workers risk losing access to this workforce if they do not adhere to regulations.

Compared with those in early summer, inspections in mid- and late summer revealed more violations of regulations for unsanitary conditions and cockroach infestations. Inspections occur at early season, so this is the time camps are most likely to meet regulations.⁸ Midsummer is the time of highest demand for farmworker labor, so it is also likely the greatest strain on housing resources. It is therefore not surprising that more conditions that violate regulations appear at that time and some persist into late summer. Other conditions may be less of a problem late in the season when occupancy is lower (e.g., refrigerator temperatures if fewer workers are using refrigerators). These findings suggest that postoccupancy inspections are needed to promote safe kitchen conditions through the agricultural season. The NCDOL does not conduct postoccupancy inspections, even in housing that has been cited for repeat violations, unless complaints are received.

These results should be interpreted in light of their limitations. Data were collected in eastern North Carolina, so they may not represent conditions elsewhere. Kitchen inspections were conducted only once in each camp, so they may not represent conditions at other times of the summer. We obtained no interrater reliability data, but the research team took and reviewed photographs. In about 18% of known camps, inspections could not be conducted because of refusals of growers or workers. It is impossible to know whether those camps have conditions different from those inspected. These analyses do not include health and illness data to directly link the findings to worker health and work capacity.

Nevertheless, the results represent an intensive inspection of a large number of migrant farmworker camps in a defined region. They indicate substantial threats to health and safety of migrant workers posed by the kitchen and cooking conditions, some of which appear to be similar to issues documented for migrant workers in North Carolina decades ago.^38,42 Further research should be conducted to assess the health effects of these violations. Avenues to greater frequency of inspections should be explored, particularly postoccupancy inspections that can assess adherence to regulations during the agricultural season.