Fluid Intake and Hydration Status Among North Carolina Farmworkers: A Mixed Methods Study

Abstract

Background: Agricultural workers are disproportionately at risk for heat-related morbidity and mortality. The purpose of this study was to explore how sociocultural and occupational factors, and environmental heat stress influenced fluid intake and hydration status among Latino farmworkers working in eastern North Carolina. Methods: A community-informed, mixed methods research study was conducted in partnership with staff at a federally qualified health center. In summer 2020, we recruited Latino farmworkers at migrant camps. Twenty-eight male, migrant farmworkers participated in focus group discussions and 30 completed surveys and provided urine specimens. Wet bulb globe temperatures were measured in fields where workers labored. Content analysis and parametric analyses were performed. Data integration was completed using a meta-matrix. Results: Prior to work, 46.7% of farmworkers’ urine specific gravity measurements indicated dehydration, which increased to 100% after work. The farmworkers spent between 2 and 7.5 hours of their day working in conditions above the recommended limits for workplace heat exposure. Farmworkers described exposure to extreme heat and inconsistent occupational policy compliance. Farmworkers expressed the opportunity to drink water but accessibility and poor water quality limited hydration. The integrated data supported congruent findings of extreme heat, few work breaks, and substandard housing. Conclusion/Application to Practice: Farmworkers are dehydrated at work, placing them at higher risk for heat-related illness (HRI). By engaging with agricultural stakeholders, occupational health nurses can combine efforts and advocate for effective health and safety work policies to reduce HRIs and deaths among farmworkers. Legislation stipulating cooling and hydration practices would support safer work environments.

Hired crop worker injury risks on farms in the United States during three different periods between 2002 and 2015

“…And that these farmworkers spent the majority of their shift working in temperatures above the recommended limits for workplace heat exposure. 39 Another farmworker study reported that dehydration was related to decreased kidney function, kidney function significantly decreased between pre-and postharvest, and that pesticide exposure needs to be considered along with dehydration status and heat stress. 40 Relationships between field sanitation, size of employer, type of employer, and occupational exposures collected using walk-through surveys also warrants additional consideration.…”

“…Dehydration may result in mental and physical fatigue, less attention and focus, or balance‐related problems, which could predispose the crop workers to illness or injuries. Mizelle et al 39 reported that hydration status, measured by urine specimens, among North Carolina farmworkers significantly deteriorated to the extent they were dehydrated or severely dehydrated by the end of a workday. And that these farmworkers spent the majority of their shift working in temperatures above the recommended limits for workplace heat exposure 39 .…”

“…Mizelle et al 39 reported that hydration status, measured by urine specimens, among North Carolina farmworkers significantly deteriorated to the extent they were dehydrated or severely dehydrated by the end of a workday. And that these farmworkers spent the majority of their shift working in temperatures above the recommended limits for workplace heat exposure 39 . Another farmworker study reported that dehydration was related to decreased kidney function, kidney function significantly decreased between pre‐ and postharvest, and that pesticide exposure needs to be considered along with dehydration status and heat stress 40 .…”