IRSST - Institut de recherche Robert-Sauvé en santé et en sécurité du travail

Preventing skin exposure to pesticides in apple growers and factors affecting use of protective clothing

Abstract

International research demonstrates that the skin is the main route of exposure to pesticides used in agriculture. The use of personal protective equipment (PPE) plays a key role in preventing the risks of exposure. However, failure to use prescribed PPE systematically is well documented and has become a prime target of initiatives to reduce exposure to pesticides. This study expands on the findings of a first investigation of apple growers by looking specifically at skin exposure to pesticides and the use of protective clothing (PC). The purpose was to describe exposure situations during the main activities involved in using pesticides and to compare them to apple growers’ perceptions of risk, use of PC and prevention practices. The study findings advance our knowledge of the factors that facilitate or hinder use of PC.

The first step was a literature review that looks at different perspectives on PPE use in general and PC use in particular. The use of PPE and PC, their definitions, characteristics and effectiveness and the way they are used was examined and the results of studies with diverse perspectives on PPE use or prevention practices are presented.  Knowledge and perception of risk have always been considered key variables in explaining PPE use. Thanks to advancement of knowledge, the need to consider factors related to the social and economic context in order to understand and influence growers’ PPE use practices is now also recognized.

The review also examines methodological features of the studies of PPE use, making it possible to situate the particular contribution of this study. For one thing, the heterogeneity of the studies of PPE users, in particular the populations studied, the data collection methods and the variety of items studied, make it difficult to compile results and draw conclusions. In addition, the methods used to measure exposure in epidemiology and toxicology do not provide information on how exposure occurs. Field studies, often ergonomic or sociology of work studies, use work observation and interviews to describe work and exposure, including PPE use, in real circumstances.

For this study, a methodology based on sociology of work and ergonomics was used to study usual practices among apple growers for protection against skin exposure to pesticides under a variety of exposure conditions. Data were collected from a small number of volunteer growers during the pesticide mixing-loading and application (spraying) phases. Repeated observations and interviews under conditions differentiated according to predetermined variables made it possible to study a number of work and exposure situations during which PC is worn and contributed to the validity of the results. Systematic analysis of videos of activities made it possible to describe many components of the work settings and the activity phases, study routine exposure situations associated with contact with pesticides and observe many facets of PC use. Analysis of the interviews enriched and validated our understanding of exposure situations, prevention practices and PC use.

Qualitative analysis of the observations highlighted the significance of the varied, repeated, routine “microexposure” situations, where exposure is low in intensity, of short duration, not highly visible and an integral part of activities. These situations are related to actions, movements and manipulations that are frequently repeated and associated with activity determinants. In fact, incidents causing unexpected, major exposure and disturbance in the conduct of the activity are infrequent. These repeated microexposures added a quantitative dimension to observation analysis, and a hypothesis of cumulative skin exposure during the activities observed was formulated. In the absence of quantifiable, biological exposure measures, this information can help to make users aware of pesticide-related risks and encourage implementation of effective skin protection measures.

The growers who participated in this study wore work clothes with long sleeves and long pants as well as PC in most of the exposure situations analyzed. However, there was considerable variety in the PC worn and it was not always used as recommended on the pesticide labels or in a way that ensured the desired level of protection. The growers expressed their concerns about their health and their doubts about the efficacy of the PC they use. The literature review confirms that real protection does not always match anticipated protection. These findings are related to a number of weaknesses/knowledge gaps with respect to PC sold in Québec, particularly with regard to certification, clear labelling, recommendations for PC use depending on exposure situation and data on PC use and its distribution. The effectiveness, thermal comfort, suitability for work and cost of PC also affect its use.

The data demonstrate, however, that apple growers also rely on trade know-how in developing and implementing prevention practice that are integrated in the normal course of their activities and that they present as complementing the use of PC. These findings suggest that practices that do not comply with recommendations may be adaptations to routine microexposure situations, lack of information about PC or rules unsuited to the realities of the growers’ work and needs. The prevention practices show the growers’ concern about the risks associated with their work.

Thanks to a combined sociological and ergonomic approach, this project generated findings and recommendations firmly rooted in the realities faced by growers. The participation of farm workers in developing, testing and validating safety rules through growers’ collectives could yield outcomes that promote better protection against pesticide exposure. Collaboration between the agricultural community and those who work in public health in particular will make it possible to design measures grounded in the realities of the growers’ work and social dynamics.