Pesticide-related illness among migrant farm workers in the United States.

Surveillance data show that pesticide-related illness is an important cause of acute morbidity among migrant farm workers in California. A few categories (organophosphates and carbamates, inorganic compounds, and pyrethroids) account for over half of the cases of acute illness. Skin effects dominate the illnesses, although ocular and systemic effects are also common. Exposures occur in various ways (e.g., residues, drift), suggesting that the use of pesticides creates a hazardous work environment for all farm workers. The health care system provided through the Migrant Health Program appears to be underutilized, partially due to barriers to health care access. Pesticide hazards should be ranked based on acute toxicity, chronic toxicity (including reproductive risks), carcinogenic potency, volume applied, and magnitude of worker poisonings. Current surveillance effort should be supported. Risk prevention should focus on substitution of safer compounds, establishing effective protections, and ensuring that these measures are enforced. Improved education for health care providers should be a priority. Growers should be educated about alternative forms of pest control and incentives should be provided to encourage their use.