Kudos to AnnMarie Walton, assistant professor, and her entire team for the submission of her Southeast Center for Agricultural Health and Injury Prevention/University of Kentucky Pilot grant application entitled “Engaging Farmworker Health Outreach Workers in Professional Development: The Refinement of a Handwashing Educational Toolkit for Spanish-Speaking Farmworkers." This proposal requests funding for a one-month period with a start date of Sept. 1, 2019.

While farmworkers may not directly apply pesticides, they can be exposed to pesticides through breathing vapors and dusts from pesticide drift into unintended areas (inhalation); through the skin or eyes when handling treated plants and soil or touching contaminated equipment and clothing (dermal/ocular exposure); and through eating, drinking, and other hand-to-mouth behaviors with unwashed hands (ingestion) (Krieger, 2010). The dermal route of exposure is most significant for farmworkers (Krieger, 2010).  

Scenarios whereby farmworkers may experience dermal exposure include being sprayed directly with pesticides, not washing hands after touching items containing pesticide residues, wearing pesticide-contaminated clothing, and using inadequate pesticide protective clothing and equipment while working. Furthermore, the skin covering some parts of the body is more likely to absorb pesticides because of its highly vascular nature and reduced skin thickness (e.g., the genitals, underarms, scalp, and forehead) (Feldmann & Maibach, 1970).  One recommended strategy for minimizing dermal exposure to pesticides is handwashing (Curwin, Hein, Sanderson, Nishioka, & Buhler, 2003).

Pesticide exposure is associated with both acute and long-term adverse health effects.  In the short term, pesticide exposure can cause irritation of the respiratory tract, skin, and eyes.  Pesticide poisoning occurs when a person has been exposed to high levels of pesticides over a short period of time and may result in nausea, vomiting, diarrhea, headache, and dizziness.  Long-term effects of lower-level exposure include certain cancers, neurological problems, and reproductive issues (Hoppin & LePrevost, 2017). 

The handwashing educational toolkit is the product of a participatory development process that engaged farmworker health outreach workers in every stage from needs assessment to method and message selection and, ultimately, educational material development. The handwashing educational toolkit also represents a collaboration with the North Carolina Farmworker Health Program, a federally-funded migrant health voucher program that approached us about partnering to improve handwashing education after reading about our recent research findings regarding the lack of handwashing utilized by North Carolina farmworkers in the field (Walton, LePrevost, Wong, Linnan, Sanchez-Birkhead, & Mooney, 2016). The overarching goal of the toolkit is to improve educational materials and, ultimately, handwashing practices used by farmworkers across the state.

The handwashing educational toolkit has the potential to not only increase the knowledge of farmworkers and improve their handwashing practices, reducing their exposure to pesticides, but also to improve the knowledge, self-efficacy, and learner-centered practices of farmworker health outreach workers, empowering them as educators. The toolkit and an instrument for use with farmworker health outreach workers will be implemented in a larger scale study of the efficacy of the handwashing educational intervention and associated professional development to improve handwashing behaviors and reduce pesticide exposure (as measured by hand wipe samples) among farmworkers as well as to increase knowledge, self-efficacy, and learner-centered practices of farmworker health outreach workers.