Agricultural Chemical Safety Training Materials for Farmworkers: Review and Annotated Bibliography

Abstract

Preventing or reducing exposure to agricultural chemicals is an important focus for health educators serving migrant and seasonal farmworkers and their families. The development of the US Environmental Protection Agency Worker Protection Standard requiring that farmworkers receive pesticide-related training created a demand for culturally appropriate and effective training materials, yet no compendium of such materials exists. This paper reports the results of a search for and evaluation of training materials designed for use with farmworkers. There is considerable redundancy in the training materials currently available to health educators. Few items address the health issue of chemical residues in the fields, an important source of low level chronic chemical exposure for farmworkers. There are no published evaluations of the effectiveness of any of the materials. Our review suggests the need for further development and testing of appropriate training materials to reduce the exposure of farmworkers to agricultural chemicals.

Preventing or reducing exposure to agricultural chemicals is an important focus for health educators serving migrant and seasonal farmworkers and their families. Acute chemical poisoning can be life threatening, and chronic low level exposure to agricultural chemicals and their residues has been implicated in neurological impairment, cancer, and reproductive problems.^1,2 Agricultural chemicals include a variety of pesticides (e.g., herbicides, insecticides, fungicides), fertilizers, ripening agents, and fuels. The particular chemicals used depend on the type of crop cultivated, time of year, weather conditions, and types of pests present. While some crops have fairly standard application practices, others (e.g., flue-cured tobacco) receive chemical treatment specific to micro-environmental conditions in particular fields. These varying patterns of usage and the fact that farmworkers frequently work in several different crops in a year make it difficult for workers to know to what chemicals they might be exposed. Therefore, a fairly generic safety training is appropriate.

There are an estimated 4.2 million seasonal and migrant farmworkers and their dependents in the United States, with 1.6 million classified as migrant.³ Migrant and seasonal farmworkers now work in at least 42 of the 50 states. While some areas of the United States have routinely employed large numbers of seasonal and migrant farmworkers, other areas are experiencing a dramatic increase in these workers as family labor gives way to hired labor, as well as a change in the ethnicity of workers. For example in North Carolina, which ranks fifth in the size of its farmworker population, most farmworkers 10 years ago were African-American. Today only 10% are African-American; most, like the rest of the US farmworker population, are Hispanic.⁴

These changes in the distribution and composition of the farmworker population have resulted in considerable demand for effective and culturally appropriate health education materials that can be used with farmworkers and their families by public and private providers of health services. This need was intensified in 1992 with the promulgation of the US Environmental Protection Agency (EPA) Worker Protection Standard (WPS), with full implementation of regulations to be in place by April 15, 1994.⁵ Among other requirements, the WPS states that farmworkers must receive worker-safety training that covers eleven specific topics related to pesticide exposure (Table 1). As part of the implementation of the WPS, the EPA commissioned the development of several health education items to be used by farmers and health educators to meet the farmworker training requirement of the WPS. Other groups ranging from state cooperative extension services to local and regional farmworker advocacy groups have also developed materials. These materials are highly varied, having been developed for different segments of the farmworker population by different groups. They are also often difficult to find and vary in quality, including whether or not they meet the WPS requirements. Despite their being in demand, no central compendium of these materials exists, and there has been no systematic evaluation of them.

TABLE 1.

Information required by US Environmental Protection Agency Worker Protection Standard to be included in farmworker training.

Descriptions of where and in what forms pesticides may be encountered during work activities. Hazards of pesticides resulting from toxicity and exposure, including acute and chronic effects, delayed effects, and sensitization. Routes through which pesticides can enter the body. Signs and symptoms of common types of pesticide poisoning. Emergency first aid for pesticide injuries or poisonings. Instructions on how to obtain emergency medical care. Routine and emergency decontamination procedures, including emergency eye flushing techniques. Hazards from chemigation and drift. Hazards from pesticide residues on clothing. Warnings about taking pesticides or pesticide containers home. Requirements of the WPS designed to reduce risks of illness or injury resulting from workers’ occupational exposure to pesticides, including application and entry restrictions, the design of warning sign, posting of warning signs, oral warnings, the availability of specific information about applications, and protection against retaliatory acts.

To help meet this need for a listing and evaluation of materials, we have compiled this critical review and annotated bibliography. It presents the results of a search for health education materials appropriate for use with farmworkers and related to agricultural chemical exposure. This search was undertaken as part of a research project (PACE: Preventing Agricultural Chemical Exposure among North Carolina Farmworkers) funded by the National Institute of Environmental Health Sciences to develop, evaluate, and disseminate culturally appropriate interventions among migrant and seasonal farmworkers. In this review, we describe the types of materials available, rate the comprehensiveness of the educational objectives for meeting the WPS, and suggest strengths and weaknesses of the materials. We provide annotations of some of the best items from the different types of materials. The information presented in this review includes detailed current information on sources for the materials. This review and bibliography will be a resource to health educators and others working with farmworkers, farmers, and farm families.

METHODS

Search Strategy.

To develop our bibliography of agricultural chemical safety training materials, we reviewed farm safety reference materials, searched computer data bases, searched farm safety materials catalogs, and contacted organizations involved in farmworker safety. We limited our search to the period since 1988. This temporal limitation was set to include only contemporary materials, particularly those materials that would be appropriate for meeting WPS training requirements.

The farm safety reference materials reviewed include the University of California at Davis Pesticide Farm Safety Center Pesticide Safety and Training Materials Catalog (Catalogo de Materiales Educativos y Proteccion sobre Pesticidas);⁶ the US Environmental Protection Agency Worker Protection Standard: Materials Developed by EPA, States and Other Organizations;⁷ and Agricultural Safety and Health: A Resource Guide.⁸

Three computer data bases were searched. MEDLINE (National Library of Medicine) and PsychLIT (American Psychological Association) were searched with the keywords “Farm,” “Farmworker,” “Pesticide and Intervention,” “Fieldworker,” and “Pesticide and Training.” The Rural Information Center, National Agricultural Library searched its computerized data base Agricola based on a discussion of the materials we were targeting.

We reviewed three catalogs for farmworker training materials: Gempler’s 1998 Master Catalog,⁹ a commercial farm safety materials catalog; Novela Health Education Catalogue,¹⁰ and Resource Catalog of the National Center for Farmworker Health.¹¹

Several organizations involved in farmworker issues or pesticide education were contacted to learn about any farmworker training materials that they had developed or knew about. These included the Association of Farmworker Opportunity Programs, Arlington, Virginia; PATH (Program for Appropriate Technology for Health), Washington, DC; the University of California, Statewide Integrated Pest Management Project; and the US Environmental Protection Agency.

The search process produced 35 relevant items published since 1988 that we were able to obtain and review. A number of other items were out of print or otherwise unavailable. We chose to include only items that users of this annotated bibliography will be able to obtain. These include a variety of print materials (e.g., pamphlets, posters), training manuals and curricula, and audiovisual products. Because so much of this material is difficult to find, the list may not be exhaustive. A complete annotated bibliography¹² is available from the authors and addenda to it will be available in the future.

Review Process.

Review and annotation procedures were standardized so that all materials were reviewed in the same way. All authors conducted reviews. Two reviewers were assigned to each item in the list. Each person was assigned items in every category and paired with every other reviewer to reduce the chance of bias. Reviewers used a standard set of criteria and a standard form to record reference information and their evaluation of the item. Information included title, source, author, date of publication, language of presentation, description of item, level of literacy required of users, and summary of focus and content. Evaluation items included completeness of the materials (for WPS), quality of the production, orientation to the learner, and an overall evaluation of strengths and weaknesses. Reviewers completed their evaluations independently. The two reviews for each item were then reconciled by two authors. There were few disagreements on reviews, and these were resolved by having these two authors review the item again.

The goals of the review process were to provide an accurate description of the farm safety materials and to provide some evaluation of quality, completeness, and appropriateness of materials for farmworkers. We did not test the effectiveness of any of the materials in changing farmworker knowledge, behavior, or chemical exposure. Such tests are badly needed, but are beyond the scope of this review.

RESULTS

The results of the search are detailed in Tables 2–4. Complete annotations for selected items are included in Appendix 1. Items were selected for inclusion in the Appendix to present a range of types of materials available, including those that stand out as innovative or creative and those produced by EPA because they are the most widely available. Both strengths and weaknesses are indicated.

TABLE 2.

Print materials found in search and reviewed. Complete annotations for titles in boldface type are located in Appendix 1.

Format	Title (Author)	Date	Source1	Desc.	Aud.2	Lang.3	WPS4
Comic	Cuidate (Mark Lyons, Sa-Lantic Health Services)	1992	CATA: el Comité de Apoyo a los Trabajadores Agrícolas P.O. Box 458,4S Delsea Drive Glassboro, NJ 08028	12 pp	HFW	S	No
Comic	Podemos Protegernos de los Pesticidas (Danny Torres & Mary Lyons, Dept. of Occupational Health-New Jersey)	1990	New Jersey Health Dept. (609) 984–1863	20 pp	HFW	S	No
Foto-novela	Dancing with Danger: A Pesticide Worker Protection Story/Bailando con el Peligro: Una Historia para que se Cuide de los Pesticidas (Steve Derthick & Robert L. McLymore)	1994	North Carolina Cooperative Extension Service North Carolina State University Raleigh, NC 27695	16 pp	HFW	E	No
					NFW	S
Brochure	Salud: Los Pesticidas (Anonymous)	1989–1991	BOCES Geneseo Migrant Center Holcomb Building 210 Geneseo, NY14454	1 p	HFW	S	No
Brochure	Salud: Insecticidas-Lavar la Ropa (Anonymous)	1989–1991	BOCES Geneseo Migrant Center Holcomb Building 210 Geneseo, NY 14454	1 p	HFW	S	No
Brochure	The Ten Commandments Against Pesticides/Los DiezMandamientos Contra Los Pesticidas (Anonymous)	1995	North Carolina Farmworkers Project 303 South Market Street Benson, NC 27504	1 p	HFW	E	No
						S
Brochure	Protect Yourself from Pesticides/Protéjase de los Pesticidas (US Environmental Protection Agency)	1994	US EPA Office of Pesticide Programs 401 M Street, SW Washington, DC 20460	6 pp	HFW	E	No
					NFW	S
Brochure	Steps to Protect Yourself from Pesticides/Pasos a Seguir para Protegerse de los Pesticidas (US Environmental Protection Agency)	1995	US EPA Office of Pesticide Programs 401 M Street, SW Washington, DC 20460	25 pp	HFW	E	YES
					NFW	S
						H
Brochure	Protect Yourself from Pesticides-Guide for Agricultural Workers/Protéjase de los Pesticidas-Guía para los Trabajadoes Agrícolas (US Environmental Protection Agency)	1993	US EPA Office of Pesticide Programs 401 M Street, SW Washington, DC 20460 Gempler’s Item # HW20	43 pp	HFW	E	Yes
					NFW	S
Brochure	Washing Pesticide-Contaminated Clothing/El Lavado de la Ropa Contaminada con Pesticidas (North Carolina Cooperative Extension Service)	1994	North Carolina State University College of Agriculture & Life Sciences Raleigh, NC 27695	1 p	HFW	E	No
					NFW	S
Brochure	Pesticides and Human Health: Tobacco/Los Pesticdas y la Salud: Tobacco (W. Gregory Cope et al.)	1998	North Carolina Cooperative Extension Service North Carolina State University Raleigh, NC 27695	6 pp	HFW	S	No
Brochure	Debemos Saber y Recordar/We Should Know and Remember (North Carolina Department of Labor)	1997	North Carolina Dept. of Labor Agricultural Safety & Health Section 413 North Salisbury Street Raleigh, NC 27603–5942	6 pp	HFW	S	No
Poster	Protect Yourself from Pestiddes/Protejase de los Pesticdas (US Environmental Protection Agency)	1994	US EPA Office of Pesticide Program 401 M Street, SW Washington, DC 20460 Gempler’s Item # P928	23″	HFW	E	No
				35″	NFW	S
Book	Cosecha Dolerosa: Campesinos y Pesticidas, Parte 1 Trabajadores en el Fil (Marion Moses)	1992	Pesticide Education Center P.O.Box 420870 San Francisco, CA 94142	71 pp	HFW	S	No
					NFW
					SP

¹Gempler’s 1998 Master Catalog, Gempler’s, 100 Countryside Drive, P.O. Box 270, Belleville, WI 53508

²Language E = English, S = Spanish, H = Haitian Creole

³HFW = Hispanic Farmworker, NFW = Non-Hispanic Farmworker, GR = Grower, AP = Applicator, CH = Children, SP = Service Provider

⁴Yes = Material covers all points of the Worker Protection Standard, No = Material does not cover all points of the Worker Protection Standard.

TABLE 4.

Audiovisual materials found in search and reviewed. Complete annotations for titles in boldface type are located in Appendix 1.

Format	Title (Author)	Date	Source1	Desc.	Aud.2	Lang.3	WPS4
Video	Siguiendo el Sol/Chasing the Sun (Deliana Garcia, Jon Lacy, Diane Weidenkopf)	1994	National Migrant Resource Program, Inc. 1515 Capital of Texas Highway South Ste. 220 Austin, TX 78746 Gempler’s Item #V210	36 min	HFW	E	Yes
					NFW	S
Video	You Can Do It: How to Teach Pesticide Health and Safety to Farmworkers and Their Families (Alice Larson & Judith Ruskin)	1991	US EPA, Region X 1200 Sixth Avenue Seattle, WA 98191	26 min	GR	E	No
					SP
Video	Pesticide Handlers and the Worker Protection Standard (Michigan State University Cooperative Extension Service)	1994	Michigan State University Cooperative Extension Service 11 Agricultural Hall East Lansing, MI 48824–1039 Gempler’s Item #V400 (Eng), #V405 (Span)	50 min	HFW	E	Yes
					GR	S
					AP
Video	Pesticide Saftey: Worker Protection (College of Agriculture, University of Idaho)	1997	Agriculture Communications Center University of Idaho Moscow, ID 8394–2332 Gempler’s Item #V100	72 min	HFW	E	Yes
					NFW	S
					AP
Video	Ptotect Yourself from Pesticides (SOS Communications)	1994	SOS Communications 2999 Monterey/Salinas Highway Monterey, CA 93940	26 min	HFW	E	Yes
					NFW	S
Video	Pesticide Training for Agricultural Employees (Farm Employers Labor Service)	1995	Farm Employers Labor Service 1601 Exposition Boulevard, FB7 Sacramento, CA 95815	63 min	HFW	E	Yes
					NFW	S
Video	The Playing Field (Kelly Blake MacAluso & Diane Weidenkopf)	1992	National Migrant Resource Program, Inc. 1515 Capital Texas Highway South Suite 220 Austin, TX 78746	18 min	HFW	S	No
					CH	E
					SP
Video	Long Term Health Effects of Pesticide Exposure (University of California Communications Services)	1994	UC Communications Services University of California-Davis Davis, CA 95616	25 min	NFW	E	No
					GR
					AP
					SP
Video	Harvest of Sorrow: Part 1-Fieldworkers/Cosecha Dolerosa Parte 1-Trabajadores en el Fil (Marion Moses & Lorena Parlee)	1992	Pesticide Education Center P.O. Box 420870 San Francisco, CA 94142	30 min	HFW	E	No
					NFW	S
					SP
					TR
Audio Cassettes	Radio Pesticida (Lynne Diane Mull & Beth Outterson	1997	Association of Farmworker Opportunity Programs 1611 North Kent Street, Suite 910 Arlington, VA 22209	6 tapes	HFW	S	Yes

¹Gempler’s 1998 Master Catalog, Gempler’s, 100 Countryside Drive, P.O. Box 270, Belleville, WI 53508

²Language E= English, S= Spanish, H = Haitian Creole

³HFW = Hispanic Farmworker, NFW = Non-Hispanic Farmworker, GR = Grower, AP = Applicator, CH = Children, SP = Service Provider

⁴Yes = Material covers all points of the Worker Protection Standard, No = Material does not cover all points of the Worker Protection Standard.

Print Materials.

Fourteen print items were reviewed (Table 2). These ranged from informational brochures and posters to comics and a fotonovela. A number of the brochures are focused on a single aspect of safety training (e.g., laundering work and non-work clothing separately). Virtually all those published by the US EPA have similar simple line drawings and text. There is little variation in the wording of concepts from one EPA publication to the next. Several print items use literary devices to create interest, including comic book format and a fotonovela. With the exception of several EPA publications, none of the print materials covers all the points required in a Worker Protection Standard training. Many of these materials are available in Spanish.

Because small brochures and tip sheets are easily and economically produced, it is likely that there have been far more print items produced than any other category of safety training materials. Some are not copyrighted, authors are not clearly indicated, and publishers range from advocacy groups to health care providers and state and federal agencies. Most of the print materials require at least some reading by the farmworker audience, but the reading level varies considerably. The EPA materials have text and illustrations that are relatively generic; some of the state or local productions are focused more on local crops.

This range of print materials is represented in the annotated items (Appendix 1). They include a comic book, a single-page tip sheet, a crop-specific brochure, and an EPA brochure. The comic (Annotation #1) and tip sheet (Annotation #2) both use literary techniques (a fictionalized action scenario and a Ten Commandments format) that are empowering to the farmworker, providing safety information while urging farmworkers to be proactive in protecting themselves from agricultural chemicals. The crop-specific brochure (Annotation #3) is directed toward tobacco and is part of a series on crops typical of North Carolina and other parts of the southeastern United States, but its format could be adopted for other crops. Like it, the EPA brochure (Annotation #4) presents safety information in a neutral way. While hygienic practices of the WPS are presented (e.g., hand washing before using toilet facilities in the field and observing no-entry time intervals), they assume that farmers will be in compliance with the WPS requirements (e.g., by providing water and posting signs indicating recent chemical application).

The number and variety of print materials available means that anyone choosing print materials must carefully consider the needs and appropriate orientation for safety training materials that they use.

Training Packages.

Eleven training packages were reviewed (Table 3), including one game, one flip chart, two curricula, and seven training manuals. In general, these items are more comprehensive than the print items. Many, but not all, cover all requirements of the WPS. These training packages have been developed for several different approaches, including the training of camp health aides and other service providers, children, and farmworkers.

TABLE 3.

Curricula and related teaching materials found in search and reviewed. Complete annotations for titles in boldface type are located in Appendix 1

Format	Title (Author)	Date	Source1	Desc.	Aud.2	Lang.3	WPS4
Game	La Loteria de los Pesticidas (University of California, Statewide Integrated Pest Management Project)	1994	Publications Div. of Agriculture & National Resources University of California 6701 San Pablo Avenue Oakland, CA 94608–1239	Cards for 16 players	HFW	S	No
Flip Chart	Protect Yourself from Pesticides: Safety Training for Agricultural Workers/Protéjase de los Pesticidas-Una Programa de Seguridad Trabajadoes Agrícolas (US Environmental Protection Agency)	1994	US EPA Office of Pesticide Programs 401 M Street, SW Washington, DC 20460 Gempler’s Item # FC100	84 pp,	HFW	E	Yes
				11″	NFW	S
				17″
Curriculum	ESL for Farm Safety: Student Workbook/Teacher’s Manual (Kathleen Flannery Sile & Beth Outterson)	1997	Association of Farmworker Oppotunity Programs 1611 North Kent, Suite 910 Arlington, VA 22209	95 pp	HFW	E	Yes
				158 pp
Curriculum	The Playing Field: A Curriculum Guide to Pesticide Education, for Foruth, Fifth, & Sixth Grades (Diane Bellissemo & Deliana Garcia)	1994	National Migrant Resource Program, Inc. 1515 Capital of Texas Highway South Suite 220 Austin, TX 78746	52 pp	CH	E	No
Manual	The Illustrated Guide to Pesticide Safety (Melanie Zaval)	1991	Div. of Agriculture & Natural Resources University of California 6701 San Pablo Avenue Oakland, CA 94608–1239	Worker Ed. 4 pp	HFW	E	No
				Instructor Ed.72 pp		S
Manual	Fieldworkers and Pesticides: A Trainer’s Manual, 2nd ed. (Melanie Zavala & Jennifer Weber)	1996	Pesticide Education Program Statewide Integrated Pest Management Project University of California Davis, CA 95616	120 pp	SP	E	Yes
Manual	Instructor Guide: Field Sanitation and Worker Personal Cleanliness/Guia de Entrenamiento para Instructores: Higiene Personal del Trabajador y Limpieza el Campo (UC-Davis, Agriculture Health & Safety Center)	1992	Dept. of Applied Behavioral Science University of California-Davis Davis, CA 95616	8 pp	GR	E	No
						S
Manual	Peligro: Trabajamos con Venenos/Danger We Work with Pesticides (Anonymous)	????	Farmworker Health & Safety Institute 2001 “S” Street, Suite 210 Washington, DC 20009	90 pp	HFW	S	Yes
					NFW	E
Manual	Protect Yourself from Pesticides: Safety Training for Agricultural Workers (US Environmental Protection Agency)	1993	US EPA Office of Pesticide Programs 401 M Street, SW Washington, DC 20460	34 pp	SP	E	Yes
Manual	Camp Health Aide Manual (Chapter 6: Occupational Heath) (Midwest Migrant Health Information Office)	1997	Midwest Migrant Health Information Office 502 West Elm Avenue Monroe, MI 48162	17 pp	HFW	E	No
					NFW	S
					SP
Manual	The Worker Protection Standard for Agricultural Pesticides-How to comply: What Employers Need to Know (ISBN 0-16-041939-5) (US Environmental Protection Agency)	1993	US Government Printing Office Superintendent of Documents Mail Stop: SSOP Washington, DC 2002–9328	141 pp	GR	E	Yes

¹Gempler’s 1998 Master Catalog, Gempler’s, 100 Countryside Drive, P.O. Box 270, Belleville, WI 53508

²HFW = Hispanic Farmworker, NFW = Non-Hispanic Farmworker, GR = Grower, AP = Applicator, CH = Children, SP = Service Provider

³Language E = English, S = Spanish, H = Hispanic Creole

⁴Yes = Material covers all points of the Worker Protection Standard, No = Material does not cover all points of the Worker Protection Standard.

The game La Loteria de los Pesticidas (Annotation #5) is an example of an interactive teaching tool that might be used in conjunction with other materials. Its imitation of a Latin American bingo game orients it to Hispanic farmworkers. A user’s guide and slide set are available to aid in its use for teaching. The two manuals (Annotations #6 and #7) take a “train the trainer” approach, including both an overview of content for training sessions to be presented to farmworkers and specific materials and techniques to teach effectively. Both stress an active learning approach appropriate for adult learners. Both require a high school reading ability for the trainer, but no reading by students. Annotation #7 is the more complete manual, with detailed lesson plans included. The EPA flip chart (Annotation #8) also provides detailed lesson plans for use in a small group format. Its educational approach is the most passive of these training packages, with a complete script provided and no extra activities beyond discussion suggested. The curriculum in Annotation #6 takes the most empowering stance, using the Frierian approach to raise the awareness of workers and encourage problem solving.

All of these training packages are designed to be used by lay health workers, outreach workers or others who may have no specific training related to agricultural chemicals and their health effects. There is little or no background information in any of the training packages to provide these persons with additional information on the rationale for what they are teaching or to answer questions posed by farmworkers. This leaves such instructors unable to elaborate on training messages or answer worker questions. There may be need of supplementary background materials provided for trainers who use these packages.

Audiovisual.

Ten audiovisual items were found, including nine videos and one set of audio cassettes (Table 4). The educational approaches of these items are quite varied, ranging from one that shows learners being lectured in a typical classroom situation to a more engaging mixed presentation of visuals and graphics. The sound and visual quality is equally varied. Some are new and well-produced; others consist of older existing video segments strung together to make an uneven production, with a dated appearance.

The content of some of these materials goes beyond the WPS to include materials required for the training of chemical applicators. This should be taken into account when choosing a video, as it means relatively less time spent on information pertinent to farmworkers. Because simply watching a video may be the bulk of a WPS training, the content, approach, and appeal of these take on greater significance than with other materials that may be part of a broader training presented in person by an instructor. A few come with instructors manuals.

The variety in audiovisual materials is reflected in those annotated. One (Annotation #9) uses a dramatic story line with farmworkers skeptical of the need for training to convey information about reducing chemical exposure. It mixes Spanish and English in a natural way, to permit either Spanish or English speakers to understand the content. Other videos (Annotations #10 and #12) use a more standard didactic approach and have separate Spanish and English segments. The annotated videos are high quality productions with a contemporary look. Their content covers the WPS, but expands it somewhat, including making suggestions of ways farmworkers can operationalize the safety behaviors suggested by the WPS (Annotation #9). Cartoon figures and graphics are used in one video (Annotation #12), but they seem to be based on the text and drawings of the EPA brochures. The appearance is somewhat flat and two-dimensional, and the content, while covering the WPS points, adds no detail or elaboration. In contrast to this is a recently produced set of audio cassettes (Annotation #12) containing a variety of dramas (novelas and talk-shows) that can be used as radio broadcasts or in a teaching context. These are lively, engaging, and of very good sound quality.

DISCUSSION

Although our search produced 35 items for training farmworkers about agricultural chemical safety, the review of the materials demonstrates that there is considerable redundancy across items and categories. Since the publication of print WPS training materials by the EPA in 1994,⁷ the text and drawings from these materials have been reproduced with few changes in a variety of newer publications. The text in many of the EPA materials was originally written for a low literacy audience, so is quite simple and not necessarily appropriate for scripts of videos or instructor-delivered lessons. Nonetheless, it has been used in those media, resulting in what is probably an underestimation of the learning capacity of the audience and a fairly small amount of information being covered. Because there is so much redundancy, the use of several items in a training program (e.g., a video, a pamphlet, and a poster) may help reinforce a limited number of concepts, but add no further explanation.

The text content of many of the materials reviewed is prescriptive with no rationale provided. There is little or no attempt to explain why a behavior like hand washing should be practiced or why others such as combining work and family laundry should be stopped. The rationale may seem obvious to the trainers or to those who develop the materials, but it will not necessarily be so to the users. Health education research indicates that if a rationale is taught, a person is more likely to practice a new behavior. In addition, understanding the rationale empowers workers by allowing them to transfer the behavior to new situations. This failure to explain WHY a behavior is important may be the greatest shortcoming of the materials reviewed.

A review of the educational content of these materials shows that the discussions of the hazards of chemicals focus on chemicals that may be encountered during their application (e.g., spraying, windblown drift, chemigation, or spills). There is virtually no discussion of chemical residues that remain on plants, tools, and soil. Because the large number of days farmworkers typically spend in the field exposed to low level chemical exposure through residues results in greater exposure for farmworkers than for chemical handlers and applica-tors,¹³ there is a need for emphasizing residue exposure.

There is little crop-specific information. Some crops will contain more dangerous chemicals than others, and the routes of exposure are different because of different modes of application and physical differences in the crops. For example, picking strawberries might result in more exposure to the lower body (frequently covered by shoes and jeans) than would harvesting oranges and tobacco, where the upper body including head and neck rub against foliage. Because different parts of the body absorb chemicals at different rates,¹⁴ information related to the exposure resulting from specific crops might be useful.

There is considerable stereotyping in the depiction of roles. In most of the illustrations, health care personnel are white male physicians. Farmworkers actually seek and receive medical treatment from a variety of types of personnel, including outreach workers and nurses. Though depicted as both males and females, farmworkers have clothing and hair styles to imply that they are Mexican. This may limit the applicability of the materials when farmworkers from other ethnic groups are trained.

Although many of the items reviewed use a simple, factual presentation of information, producing redundancy in content and presentation, there are significant exceptions across all three categories of materials. The use of literary or dramatic approaches includes action comics and fotonovelas in print materials, role play and demonstrations in training packages, and radio dramas in audio visuals. Such approaches have been shown in other types of health education to be effective ways of communicating information. The fotonovela, in particular, has been advocated for use with Hispanic clients, as it is frequently read in its entirety and shared among household members.¹⁵

Many of the training materials that have been developed may not be culturally appropriate for their intended audiences, in particular those materials developed in English and simply translated into Spanish. None of the materials indicate that the author or translator considered variation in the Spanish spoken by farmworkers from different points of origin (i.e., Mexican versus Puerto Rican or Honduran). Our review showed that Annotation #1 is written in Puerto Rican vernacular, but this is not indicated on the publication. Nor have the developers of these materials begun to consider that for a growing number of these “Hispanic” farmworkers, Spanish is a second language to a Native American language. Also, translating word for word does not always capture the nuances of language.

Beyond language, the health beliefs of the workers are not considered in any of these materials. These beliefs can differ significantly from the scientific bases of the WPS recommendations. For example, Quandt and colleagues found that farmworkers in North Carolina (primarily Mexican and African American) believed that chemicals and their residues could be detected through the senses; if they could not be felt, smelled, or tasted, they were not there.¹⁸ In addition, they believed that the skin acts as an effective barrier to chemical absorption, with most chemicals entering the body through the lungs and mouth. Baer and Penzell¹⁹ found that farmworkers in Florida do not distinguish between the symptoms of pesticide poisoning and the folk illness “susto” (fright). Taking such health beliefs into account may be necessary to effectively train farmworkers.

CONCLUSIONS AND RECOMMENDATIONS

Health educators working with farmworkers to prevent or reduce exposure to pesticides and other agricultural chemicals can design WPS training using a variety of training packages or audiovisual materials. A number of different print materials are also available to supplement the oral presentation of information. Care needs to be taken in choosing materials that match the needs of the audience, based on ethnicity, language, literacy level, and types of exposure they are likely to encounter.

When they use the existing materials with farmworkers, health educators need to be aware that there have been few evaluations¹⁶ of the effectiveness of any of these materials; none has been published. The effectiveness of the US EPA Worker Protection Standard training has not been directly evaluated,¹⁷ and none of the Worker Protection Standard training materials developed by US EPA has been evaluated. Therefore, health educators should critically evaluate the content of the educational materials they choose and the appropriateness for a particular audience. Much WPS training of farmworkers is carried out by growers and others who may not understand the limitations of the materials. Health educators, including those in migrant clinics and Cooperative Extension need to focus efforts on informing growers of the strengths and limitations of different materials and on assisting them in choosing the best materials for training fieldworkers.

In addition, continued development of engaging and innovative materials is needed, rather than replication of existing EPA materials. New materials should put greater emphasis on the hazards of chemical residues and ways to reduce exposure to them. They should incorporate the rationale for recommended health behaviors. These materials need to consider the varying cultural backgrounds within the farmworker population.

APPENDIX 1. Annotations for Selected Bibliography Materials

1. Cuidate. 1992. Mark Lyons, Project Coordinator. Sa-Lantic Health Services, Rural Community Assistance Project, and CATA-El Comité de Apoyo a los Trabajadores Agrícolas. 12 page comic book.

   This is a densely illustrated action comic with text in Spanish in the form of dialogue written at a junior high to high school reading level. Its purpose is to provide workers with information about field sanitation. Sections include heat stress, protecting oneself from infectious diseases in the field, pesticide safety, and legal rights. The comic asks the worker to be proactive in requesting sanitation facilities from the grower. Information contained is relatively current, but does not cover all points of the US EPA Worker Protection Standard (WPS). Cover pages are in color, with inside pages in black and white. The illustrations are effective; they appear to depict Hispanic characters. Comic book format of illustrations and text may be too complicated for workers with limited reading skills. Content is empowering, educating workers about problems and informing them of their rights. Comic would be a good supplement to a training session or video. It could also serve as a good resource for peer trainers.

2. The Ten Commandments Against Pesticides; Los Diez Mandamientos Contra Los Pesticidas. 1995. El Proyecto de Trabajadores Agricolas (North Carolina Farmworkers Project). 1 page.

   This tip sheet uses the format of the Ten Commandment tablets (with English on one side and Spanish on the reverse) to offer “always” or “never” imperatives to prevent exposure to pesticides and their residues. Content includes portions required in WPS training. Production quality is poor. Contains considerable information to tell why certain actions are protective or dangerous, but this results in a reading level that may be above that of many farmworkers. The tone of the tip sheet is empowering to farmworkers, but confrontational to farmers. This tip sheet is a clever idea that might suggest a format for worker training.

3. Pesticides and Human Health: Tobacco/Los Pesticidas y la Salud Humana: Tabaco) 1998. W. Gregory Cope et al. 6 page brochure.

   The purpose of the brochure is to provide detailed information about agricultural chemicals and safety in a compact format. It focuses on tobacco and is meant to be the first in a series of crop specific chemical brochures. Future brochures will focus on other major North Carolina crops, such as cucumbers, sweet potatoes and Christmas trees. The brochure contains a chart detailing the chemicals used on tobacco (e.g., insecticides, growth regulators), their health effects, and their re-entry periods, as well as the basic points of the WPS. Much of the information presented is detailed, and reading for meaning would require a high school level reading ability. The print quality is legible, but some of the text is cramped. This brochure focuses on education and provides more detailed and up-to-date information about pesticides than is available in other publications. It is good for farmworkers who want more details about the chemicals with which they work, but some farmworkers may find it too technical. It would be useful to lay health advisors and trainers as a reference or as part of an interactive training.

4. Protect Yourself from Pesticides-Guide for Agricultural Workers/Protéjase de los Pesticidas-Guía para los Trabajadores Agrícolas. 1993. US Environmental Protection Agency. 43 page brochure.

   This brochure presents all the major points of the WPS at a basic reading level with black and white line drawings. Material is current, well organized and clearly presented. Two versions of the booklet are available (on newsprint or on heavier paper with cover); both have good print quality. The brochure is divided into 8 sections, each addressing a different issue for reducing risk of exposure to pesticides: pesticide safety, how you can protect yourself from pesticides, sources of pesticide exposure, how pesticides can hurt you, what to do if you get sick at work, what to do if exposed to pesticides, legal protection for farmworkers, and steps to protect yourself. Each section includes a short narrative in English followed by Spanish, with an illustration. Most of the information is simply factual; steps to protect oneself focus on what an employer is required to do, rather than empowering workers with information they can use to protect themselves. The brochure covers considerable material in general terms. Length may be a little daunting; it should be used as a review or as a supplement for a WPS training session.

5. La Loteria de los Pesticidas. 1994. University of California, Statewide Integrated Pest Management Project, UC-Davis. Game with cards for 16 players.

   This is a game designed to teach pesticide safety themes. The game itself is in Spanish, with an instruction guide in English. It is patterned on “loteria” a game played in Latin America that is similar to bingo. Themes include general pesticide information, protective equipment, employer responsibilities, and working safely and staying clean. Concepts related to these broad themes are all keyed to pictures, making it easier for individuals with limited reading skills. The Guide contains questions that correspond to the pictures. The information is current, but the game was produced in 1992 and does not cover all points of the WPS. It is of good quality, produced with bright colors and durable cards. It is educational, very much learner oriented, and suitable to reinforce training if used as a part of a broader training program. This game is appropriate for Hispanic farmworkers, and the interactive format is appealing. However, some of the content is oriented more to applicators than to field workers. Slide set is available, but was not reviewed.

6. Peligro: Trabajamos con Venenos (Danger: We Work with Pesticides). No date. Farmworker Health and Safety Institute. 90 page training manual.

   This curriculum is designed to be used by a professional health educator or lay health worker to teach a variety of information about pesticide exposure (including preventing exposure, its consequences, treatment, and legal rights of farmworkers) that would meet the WPS training requirements. The teachers manual is detailed and requires a fairly high reading level for trainers. No reading is required of students. Each section of the manual contains behavioral objectives, an interactive methodology, and materials necessary to complete the section (e.g., role-play script or flipchart). The approach is based on the learner-centered Frierian education model of raising awareness of the workers and allowing them to develop their own responses. Lessons are reasonably complete, but contain no background information for the instructor on pesticides and exposure. This manual is a copier-quality production. While not flashy, it contains some very innovative ideas for educating farmworkers with a problem-solving and empowering approach that should facilitate greater learning than many other available training packages.

7. Fieldworkers and Pesticides: A Trainer’s Manual, 2nd ed. 1996. Melanie Zavala and Jennifer Weber for University of California, Statewide Integrated Pest Management Project, Division of Agriculture and Natural Resources. 120 page training manual.

   This is a nuts and bolts guide to prepare someone to provide WPS training to farmworkers. A high school or higher reading ability is required. Each of the several chapters covers an important point for preparing a trainer: required content of training, training preparation, training techniques, and making training practical and useful. Examples are given throughout, and an appendix contains line drawings that can be reproduced for use with different training methods. This manual provides instruction for developing training sessions, but does not provide the training sessions themselves. The content is geared to federal EPA regulations as well as those specific to California, and addresses long-term low level exposure as well as acute poisoning. The presentation is even-handed, noting that both workers and growers are responsible for protecting workers from exposure. This English language manual is an excellent introduction to a trainer on how to develop and present a WPS training session.

8. Protect Yourself from Pesticides: Safety Training for Agricultural Workers/Protéjase de los Pesticidas-Una Programa de Seguridad Trabajadores Agrícolas. 1994. US Environmental Protection Agency. 84 pages.

   This flipchart has pictures for farmworkers and script for trainers designed to cover the content required by WPS for training. Although pesticide residues are mentioned, they are not included as a source of chemical exposure. Script is at high school reading level or higher; no reading is required of farmworker learners. The chart is divided into 8 sections, each containing information that faces trainers (behavioral objectives, teaching content, review questions and answers) and black and white line drawings that face farmworkers. The flipchart is sturdy and will stand on a table; it folds for carrying. It is printed in black on white cover stock and contained in a large plastic ring binder. Small size limits group with which it can be effectively used to 7–8 workers. There are no guidelines for trainers to evaluate effectiveness of training. WPS information is so consolidated in the teaching script that amplification of content by a knowledgeable trainer is needed to effectively teach material.

9. Siguiendo el Sol (Chasing the Sun). 1994. Deliana Garcia, Executive Producer, Jon Lacy, Director, Diane Weidenkopf, Producer, for National Migrant Resource Program, Inc. 36 minute video.

   This video uses a story situation of farmworkers being trained in pesticide safety to convey information on reducing exposure and administering emergency first aid. English and Spanish are spoken by actors as appropriate, with Spanish subtitled into English. The information is more detailed than EPA publications and takes the tactic of convincing a skeptical farmworker of the necessity for pesticide knowledge and exposure prevention. It is contemporary in appearance with good sound and video quality. Content and story line are more engaging than many other videos, and the approach is empowering, providing some specific suggestions of things farmworkers can do to reduce exposure or treat its effects. This video is a good tool to be used in combination with other materials to meet the WPS training requirements. It contains an excellent 5 minute review at the end of the video that provides effective reinforcement of the information conveyed in the story. This review could be used separately, with stops for discussion.

10. Pesticide Safety: Worker Protection. 1997. College of Agriculture, University of Idaho. 72 minute video.

    This is a two segment video designed to meet US EPA Worker Protection Standard training requirements for agricultural workers and pesticide handlers. There are both Spanish and English versions of each of these, making each segment approximately 18 minutes. Topics covered in the agricultural workers segment include: types of pesticides, pesticide residues, posting requirements, re-entry periods, pesticide symbols, exposure prevention, decontamination, laundry, acute and chronic effects of exposure, and symptoms and treatment. The identification, treatment and prevention of heat illness are also reviewed, as are workers’ legal rights and employer requirements. The content of the video is current. The equipment used by workers and growers, and the clothing of the actors all look contemporary. The video uses high quality text, visuals and sound to convey its message. It is even-handed in its presentation of responsibility, stating that it is up to the worker to use common sense and work safely, but also noting the employers’ obligations to the workers. This is a very good video, addressing topics such as residue and chronic effects that few other interventions mention. It uses repetition in an appropriate way to reinforce important ideas. It could be an important part of a general training program.

11. Radio Pesticida. 1997. Lynda Diane Mull and Beth Outterson. 6 audio cassettes.

    The theme of these Spanish language radio broadcast tapes is informing the listeners about personal safety. The tapes include a public service announcement (1 minute), 5 radio novelas (4–5 minutes each), and several talk shows (20–30 minutes) discussing the novellas. The content of these tapes is very current, covering the points of the WPS. The sound quality is excellent. The Service Provider’s Guide that accompanies the tapes is of professional quality and written at a fairly high reading level. One of the novelas stresses the employer’s responsibility to provide training. The other tapes emphasize workers being careful and taking responsibility for themselves. None of the tapes addresses unsafe work conditions. The presentations are well produced and appropriate for Hispanic farmworkers who listen to radio. These cassettes could also be used in other teaching situations. The dramatizations are very effective and well done. The dramatizations followed by the talk show format are long, but a very good idea.

12. Protect Yourself from Pesticides. 1994. SOS Communications. 26 minute video.

    This tape contains English and Spanish versions of the same video. The content is the same as the EPA flipchart and short brochures, reciting with little elaboration simple basic information on how to prevent exposure and on hygiene to reduce effects of exposure. The material covers the requirements for WPS training. The production uses colorful animated graphics, rather than live actors. Although it was produced in 1994, the appearance of the graphics seems out of date. The cheerful background music seems at odds with the serious nature of the subject matter and is quite distracting. The sound quality is good, but the colors on the graphics too often clash, producing a poor quality picture. This video can be used for training workers, but its concise format is best used in an interactive teaching context, not as a stand-alone instructional video.