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Background: Essential workers across multiple industries faced a disproportionate burden of morbidity and mortality during the COVID‐19 pandemic. The effects were especially severe for agricultural and food processing workers, many of whom are members of the structurally vulnerable Latine community. Under current U.S. federal laws, children under 12 years old can legally work in agriculture, one of the most hazardous U.S. industries. Many of these working youth are Latine and experience health and educational inequities. Methods: Using a community‐based participatory research approach and a qualitative design, we conducted semi‐structured in‐depth interviews in North Carolina in 2022, with service providers in health, education, and advocacy fields (n = 10) and Latine youth farmworkers aged 10–17 (n = 24). We used participatory qualitative analysis methods and a reflexive thematic analysis to understand and describe the work experiences of these youth during the first 2 years of the pandemic. Results: Amidst precarious economic and school situations exacerbated by the COVID‐19 pandemic, many youths described an increased need to work to support their families. While aware and sometimes fearful of the added occupational health risks of COVID‐19, youth and their families felt they had few other options. Service providers and youth described minimal employer‐provided safety protocols or equipment, yet some workers organized their own attempts at safety protocols. Youth narratives imply limited knowledge of basic workplace safety requirements. Conclusions: Study findings emphasize the urgent need to address structural vulnerabilities shaping workplace policies and norms to protect Latine youth farmworkers to support their healthy development. [ABSTRACT FROM AUTHOR]

Limited research has examined the health implications for youth working in United States tobacco production. Agricultural labor is hazardous, yet youth are legally permitted to be hired as farmworkers. Many youth farmworkers are members of the vulnerable Latino farmworker community. In North Carolina, youth work in many agricultural crops including tobacco. A sample of 152 Latino youth farmworkers ages 12–20 years (M = 16.7, SD = 2.0) across 19 North Carolina counties completed a cross-sectional survey and provided saliva samples in 2019. Surveys detailed personal and work characteristics. Saliva samples were analyzed for salivary cotinine and reported in geometric means (ng/ml). Bivariate associations were used to delineate the relationship between personal and work characteristics with salivary cotinine levels. Cotinine levels ranged from 0.05 to 313.5 ng/ml. Older age and working in tobacco were significantly associated with higher salivary cotinine levels. For every one year increase in age, there was a 31% increase in mean salivary cotinine levels (b = 1.31; 95% CI = [1.15–1.50]; p <.0001). Youth tobacco workers' (n = 15) salivary cotinine levels were 890% higher than those not working in tobacco (n = 137) (13.26, 95% CI = [5.95–29.56] ng/ml compared to 1.34, 95% CI = [1.03–1.75] ng/ml (p <.0001)). Latino youth tobacco workers are exposed to nicotine through their work. This exposure presents serious risk of Green Tobacco Sickness (acute nicotine poisoning) and other health concerns given the growing evidence for risk of epigenetic changes negatively affecting long-term cognitive function. Policy is urgently needed to protect this vulnerable population of adolescent workers. [ABSTRACT FROM AUTHOR]

The objectives of the present study were to describe civic attitudes and behaviors among Latinx child farmworkers in North Carolina, examine civic outcomes across relevant demographic characteristics, and discuss the implications for research on sociopolitical development among Latinx child farmworkers and for developmental theory. Descriptive statistics (count, percent, or mean, standard deviation as appropriate) were calculated for demographic and civic variables. Associations between the demographic variables and the four civic summary variables were calculated using Generalized Linear Models, the Kruskal–Wallis test, t-tests, or Chi-Square tests. Latinx child farmworkers in North Carolina (N = 169; ages 11–19, Mage = 15.8, 62.7% boys) endorsed relatively high levels of beliefs that society is fair and connections/efficacy in their communities. They reported relatively low involvement in volunteering and political activity. Future work should examine how the daily lives and experiences of child farmworkers inform their developing ideas about civic life in the US and their behavioral participation as they mature. [ABSTRACT FROM AUTHOR]

Agricultural labor is extremely hazardous, yet young children are legally permitted to work on farms. This paper contextualizes and describes Latinx hired child farmworkers' stated reasons for working. We conducted a mixed-methods study using in-depth interviews (n = 30) and survey interviews (n = 202) with Latinx child farmworkers aged 10 to 17 in North Carolina. Our qualitative thematic analysis identified children's salient reasons for working, including supporting family, contextual factors that lead to farm work, and occupying summer time. Statistical analysis showed that children's primary reasons for working included buying clothes (91.1%) and school supplies (64.7%), with few differences by gender, age, or other characteristics. The findings demonstrate that most Latinx children view farm work as a necessary but temporary experience that financially supports their families. We discuss the implications for protecting Latinx child workers by reducing their structural vulnerability in order to facilitate healthy development. [ABSTRACT FROM AUTHOR]

Background: Community-based participatory research (CBPR) facilitates vulnerable communities and scientists collaborating to address pertinent health issues. For Latinx farmworkers, the employment of children and their resulting morbidity and mortality in the hazardous farm environment is a concern. Communicating child farmworker research results to farmworkers and service providers must take into account their language, literacy, and educational characteristics. Objectives: We describe the collaborative development and dissemination of research findings on child farmworkers by a CBPR partnership with the Latinx farmworker community. Methods: Key points for communication with infographics were abstracted from peer-reviewed research papers. An iterative process sought community partners' input as the research partners developed the infographics. Lessons Learned: We developed infographics on heat-related illness, education, and musculoskeletal impacts of child labor, guided by published criteria for effective infographics. Efforts to disseminate finished infographics needed greater rigor. Conclusions: Infographics provide a means to communicate CBPR findings to community members. [ABSTRACT FROM AUTHOR]

Children as young as ten-years-old can legally work as hired farm labor in the United States. In North Carolina, many hired children are part of the Latinx farmworker community. Agriculture is a hazardous industry, and child workers experience high rates of injury, illness, and mortality. As part of a community-based participatory research study, we draw from thirty in-depth interviews with Latinx child farmworkers aged ten to seventeen to describe their experiences of personal and observed workplace injury and close calls. Nearly all child workers had experienced or observed some form of injury, with several reporting close calls that could have resulted in severe injury or fatality. Overall, children reported a reactive approach to injury prevention and normalized pain as part of the job. Highlighting Latinx child farmworkers' structural "vulnerability, this analysis contextualizes understanding of workplace injury among this largely hidden population. We offer policy recommendations to protect and support these vulnerable workers. [ABSTRACT FROM AUTHOR]

Background: Although pesticides have adverse effects on child health and development, little research has examined pesticide exposure among child farmworkers. This analysis addresses two specific aims: (1) describes pesticide exposure among Latinx child farmworkers in North Carolina, and (2) delineates factors associated with this pesticide exposure. Methods: In 2018 (n = 173) and 2019 (n = 156) Latinx child farmworkers completed interviews and wore silicone wristbands for a single day to measure pesticide exposure. Wristbands were analyzed for 70 pesticides. Results: Most Latinx child farmworkers were exposed to multiple pesticides; the most frequent were pyrethroids (69.9% in 2018, 67.9% in 2019), organochlorines (51.4% in 2018, 55.1% in 2019), and organophosphates (51.4% in 2018, 34.0% in 2019). Children were exposed to a mean of 2.15 pesticide classes in 2018 and 1.91 in 2019, and to a mean of 4.06 pesticides in 2018 and 3.34 in 2019. Younger children (≤15 years) had more detections than older children; children not currently engaged in farm work had more detections than children currently engaged in farm work. Migrant child farmworkers had more detections than nonmigrants. For specific pesticides with at least 20 detections, detections and concentrations were generally greater among children not currently engaged in farm work than children currently engaged. Conclusions: Children who live in farmworker communities are exposed to a plethora of pesticides. Although further research is needed to document the extent of pesticide exposure and its health consequences, sufficient information is available to inform the policy needed to eliminate this pesticide exposure in agricultural communities. [ABSTRACT FROM AUTHOR]

Background: Although children 10–17 years can be hired to work in agriculture, little research has addressed possible musculoskeletal injuries. Children may be at particular risk for these injuries because of the repetitive and load bearing nature of work tasks. Existing research relies on child workers to self‐report musculoskeletal injuries. Methods: In 2017, 202 Latinx child farmworkers ages 10–17 employed across North Carolina completed survey interviews. In 2018, 145 of these children (94 [64.8%] current farmworkers) completed a physical examination and second interview. The examination obtained findings for upper and lower extremity as well as back injuries. Results: Positive indicators for musculoskeletal symptoms were few in either current or former child farmworkers. The knee was most common site for positive indicators with 15.4% of children having at least one. Combining all anatomical sites, 29.0% of children had at least one positive indicator, with no significant difference between current and former farmworkers. Overall, boys had significantly more indicators of knee injuries than girls (21.3% vs. 4.1%), indicators of ankle injuries were found only in the youngest workers (9.5% of children 11–13 years), and significantly fewer current farmworkers had indicators of lower back injuries than former farmworkers (6.4% vs. 17.7%). Conclusions: Expectations of injuries come from previous studies using child farmworker self‐reports, adult farmworker injury rates, and sports medicine pediatric findings. Hired child farmworkers may not perform activities as repetitious and load‐bearing as children in sports training or adult farmworkers. Additional research using physical examination is needed to confirm these findings. [ABSTRACT FROM AUTHOR]

We examine the educational experience of Latinx hired child farmworkers in North Carolina, using a social justice framework. Qualitative (n = 30) and quantitative (n = 202) data collected among children ten to seventeen years of age revealed elevated rates of grade retention and dropout status. Children reported disruption to their schooling caused by international and interstate migration and intrastate movement. Few worked during school time; nevertheless, children reported missed participation in educational enrichment opportunities and little integration into school life. Schools often failed to accommodate language difficulties and problems caused by migration, and an atmosphere of racism prevailed. Educational programs for children in farmworker families were established during the 1960s. However, they do not meet the needs of hired child farmworkers. Policies to reduce child employment in agriculture and to meet their educational needs are necessary to ensure the education needed for future health and well-being. We discuss the applied implications of findings. [ABSTRACT FROM AUTHOR]

Background: Little research has addressed the safety environment of child farmworkers. This analysis examines the work safety culture experienced by Latinx child farmworkers in North Carolina. Methods: Survey interviews were conducted in 2017 with 202 Latinx children aged 10 to 17 years employed on North Carolina farms. Analysis included measures of the behavioral, situational, and psychological elements of work safety culture. Results: The work culture on North Carolina farms employing Latinx child farmworkers places limited value on safety. Behaviorally, many did not wear appropriate work clothing (eg, 47.5% wore gloves, 37.1% wore boots). Situationally, few received safety training for tools (40.6%), machinery (24.3%), or pesticides (26.0%); about one‐third (33.7%) had worked piece‐rate; and many did not have field sanitation services available (eg, 37.1% had water for washing, 19.8% had soap). Safety attitudes were mixed, and work safety climate was low, with 21.8% stating that their supervisor was only interested in doing the job fast and cheaply. Greater safety training, field sanitation services, and work safety climate were associated with working in western North Carolina, migrant workers, limited English fluency, and working in tomatoes. Wearing appropriate work clothing, not working piece‐rate, fewer unsafe work attitudes were associated with working in eastern North Carolina, seasonal worker, speaking English, and working in tobacco. Conclusions: This study makes it apparent that efforts are needed to improve safety culture wherever child farmworkers are employed. Current policy is not providing a safe environment for children working on farms in the United States. [ABSTRACT FROM AUTHOR]

Children as young as ten are legally hired for farm work. In North Carolina, many of these hired children are Latinx; they often work long hours during hot and humid summer conditions. Heat-related illness occurs along a continuum of severity ranging from heat cramps and rashes to heat exhaustion and heat stroke, which can be fatal. The literature on the negative health effects of occupational heat exposure is growing; however, few studies have examined this exposure and health outcomes among child agricultural workers. To understand Latinx child farmworkers' experiences of working in heat, we conducted in-depth interviews (n = 30). To estimate the prevalence of heat-related illness symptoms and associated factors, we conducted survey interviews (n = 165). Heat-related illness is common among these child farmworkers. While children often understand the dangers of working in heat, work organization often prevents their taking precautions. Formal workplace protections to prevent heat-related illness are limited. [ABSTRACT FROM AUTHOR]

Background: Children as young as 10 years of age can be hired to work on farms. Many of these hired child farmworkers are Latinx. Although these children experience high rates of injury, little research has addressed work‐safety perceptions among hired Latinx child farmworkers. Methods: For this qualitative study, we conducted in‐depth interviews in North Carolina in 2016 with 30 Latinx child farmworkers, ages 10 to 17. Our analysis used the work‐safety culture conceptual framework to delineate their perceptions of the psychological, behavioral, and situational elements of safety culture. Results: The child farmworkers describe a weak work‐safety culture. Psychologically, they understand that their parents want them to be safe, but they observe that safety is important to only a fraction of their supervisors and coworkers. Behaviorally, they recognize many of the hazards they confront while working, but it is not clear how well they use this knowledge to mitigate these hazards or to change their behaviors to avoid these hazards. Situationally, several children note that the only safety training they receive is the imperative to "be careful." Most receive little formal training, much of the training they receive is informally provided by family members and coworkers rather than supervisors, and their training is geared more toward how to complete a task than how to complete the task safely. Conclusions: Child farmworkers perceive that work‐safety culture is of limited importance in agriculture. Regulations are needed that improve work‐safety culture in agriculture, especially for those vulnerable due to minority age. [ABSTRACT FROM AUTHOR]

Background: US government child labor policies allow children as young as age 10 to be hired as workers on farms not operated by family members. Children may face substantial health risks in an industry known for high worker morbidity and mortality rates, due to high demands for productivity, and low control and little support because of the organization of the workplace. This paper examines how child farmworkers in North Carolina experience their work situation. Methods: In‐depth interviews conducted in 2016 with 30 Latinx child farmworkers, ages 10 to 17, were analyzed using concepts from the demand‐control‐support model. All had worked as either migrant or seasonal hired farmworkers within the past year. Results: Children reported planting, cultivating, and harvesting crops including fruits, vegetables, and tobacco. The crew leader supervisory system, piece‐rate pay, and coworker pressure produced significant demands to work quickly and take risks including lifting heavy loads, operating mechanical equipment, and working in excessive heat. Children had little control over work to counter demands they experienced; and they labored in a state of fear of firing, wage theft, and other sanctions. Support was variable, with younger children more likely to experience family and coworker support than older children. Conclusions: The high demands with limited control and, for some, little support, that these children experience place them at risk and show the possibility of injury and exploitation. Future research should systematically document the occupational injury and illness of hired child farmworkers, and consider whether changes in labor policy are warranted. [ABSTRACT FROM AUTHOR]

Abstract Background : Wake Forest School of Medicine (WFSM) investigators and Student Action with Farmworkers' (SAF) Levante Leadership Institute, a farmworker youth program, are collaborating on a community-based participatory research (CBPR) study. Objectives : 1) Describe the collaborative process between WFSM investigators and the Levante advisory board during the strategic planning and implementation phase and 2) highlight practices that support the collaboration and project success. Methods : The longitudinal Hired Child Farmworker Study examines the health and safety of hired Latino child farm-workers in North Carolina. Two Levante alumni co- investigators lead research-related activities with the Levante advisory board. Lessons Learned : Challenges to CBPR with youth are overcome by the longstanding partnership between WFSM and SAF, attention to logistical details, power sharing, building on shared values, and assessment of youth preferences. Conclusions : The partnership between WFSM and Levante demonstrates the mutual benefit of CBPR and will continue during the upcoming study phases. [ABSTRACT FROM AUTHOR]

Background: Although children as young as 10 years can work in agriculture, little research has addressed their occupational health. This paper describes a large, multicomponent study of hired Latinx child farmworkers, and the characteristics of children participating in this study. Methods: Survey interviews were conducted in 2017 with 202 Latinx children aged 10‐17 years employed in agriculture across North Carolina (NC). Results: Most (81.2%) participants were born in the United States, 37.6% were female, and 21.3% were aged 10‐13 years. Most (95.1%) were currently enrolled in school. Thirty‐six (17.8%) were migrant workers. 34.7% had worked in agriculture for 1 year; 18.3% had worked 4+ years. 33.7% worked piece rate. 57.4% worked in tobacco. Participants in western NC differed in personal and occupational characteristics from those in eastern NC. Conclusions: This study has enrolled a large and diverse child farmworker sample. This overview indicates several important issues for further analysis. [ABSTRACT FROM AUTHOR]

Children as young as ten-years-old can legally work as hired farm labor in the United States. In North Carolina, many hired children are part of the Latinx farmworker community. Agriculture is a hazardous industry, and child workers experience high rates of injury, illness, and mortality. As part of a community-based participatory research study, we draw from thirty in-depth interviews with Latinx child farmworkers aged ten to seventeen to describe their experiences of personal and observed workplace injury and close calls. Nearly all child workers had experienced or observed some form of injury, with several reporting close calls that could have resulted in severe injury or fatality. Overall, children reported a reactive approach to injury prevention and normalized pain as part of the job. Highlighting Latinx child farmworkers' structural "vulnerability, this analysis contextualizes understanding of workplace injury among this largely hidden population. We offer policy recommendations to protect and support these vulnerable workers.

We examine the educational experience of Latinx hired child farmworkers in North Carolina, using a social justice framework. Qualitative ( n  = 30) and quantitative ( n  = 202) data collected among children ten to seventeen years of age revealed elevated rates of grade retention and dropout status. Children reported disruption to their schooling caused by international and interstate migration and intrastate movement. Few worked during school time; nevertheless, children reported missed participation in educational enrichment opportunities and little integration into school life. Schools often failed to accommodate language difficulties and problems caused by migration, and an atmosphere of racism prevailed. Educational programs for children in farmworker families were established during the 1960s. However, they do not meet the needs of hired child farmworkers. Policies to reduce child employment in agriculture and to meet their educational needs are necessary to ensure the education needed for future health and well-being. We discuss the applied implications of findings.

Children as young as ten are legally hired for farm work. In North Carolina, many of these hired children are Latinx; they often work long hours during hot and humid summer conditions. Heat-related illness occurs along a continuum of severity ranging from heat cramps and rashes to heat exhaustion and heat stroke, which can be fatal. The literature on the negative health effects of occupational heat exposure is growing; however, few studies have examined this exposure and health outcomes among child agricultural workers. To understand Latinx child farmworkers' experiences of working in heat, we conducted in-depth interviews (n = 30). To estimate the prevalence of heat-related illness symptoms and associated factors, we conducted survey interviews (n = 165). Heat-related illness is common among these child farmworkers. While children often understand the dangers of working in heat, work organization often prevents their taking precautions. Formal workplace protections to prevent heat-related illness are limited.

Children as young as 10 years old are hired to work on farms in the United States (U.S.). These children are largely Latinx. Using interview data collected from 202 North Carolina Latinx child farmworkers in 2017, this analysis documents the heath characteristics and occupational injuries of Latinx child farmworkers and delineates characteristics associated with their health and occupational injuries. Latinx child farmworkers include girls (37.6%) and boys (62.4%), aged 10 to 17 years, with 17.8% being migrant farmworkers. Three-quarters reported receiving medical and dental care in the past year. Respiratory (15.8%) and vision (20.3%) problems were prevalent. Girls more than boys, and younger more than older children had greater health service utilization. Occupational injuries were common, with 26.2% reporting a traumatic injury, 44.1% a dermatological injury, 42.6% a musculoskeletal injury, and 45.5% heat-related illness in the past year. Age increased the odds of reporting work injuries and heat-related illness, and being a non-migrant reduced the odds of reporting work injuries. These results emphasize the need for greater documentation of child farmworker occupational health and safety. They underscore the need to change occupational safety policy to ensure that children working in agriculture have the same protections as those working in all other U.S. industries.