Summary

International research has shown that the skin is the main route of exposure to the pesticides used in agriculture. The use of personal protective equipment (PPE) plays a key role in preventing exposure. However, failure to use recommended 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 of the study was to describe exposure situations during the main activities involved in using pesticides and to link them to apple growers’ perceptions of risk, use of PC and prevention practices. The findings advance our knowledge of the factors that facilitate or interfere with the 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. PPE and PC use, definitions, characteristics and effectiveness and the way they are used are 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 the 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, helping 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 aspects 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 from the standpoint of ergonomics or the sociology of work, use activity observation and interviews to describe work and exposure, including PPE use, in real circumstances.

For this study, a method based on the sociology of work and on ergonomics was used to examine how apple growers commonly protect their skin against 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. Through systematic analysis of videos of grower activities, various aspects of the work setting and activity phases were described, common exposure situations associated with contact with pesticides were studied and many facets of PC use were observed. Analysis of the interviews enriched and confirmed our understanding of exposure situations, prevention practices and PC use.

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

The growers who participated in this study wore work clothes that included long sleeves and long pants, as well as PC, in most of the exposure situations analysed. 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 fully ensured the desired level of protection. The growers expressed their concerns about their health and their doubts about the efficacy of the PC they were using. The literature review confirms that real protection does not always match anticipated protection. These findings are related to a number of shortcomings with respect to PC available in Quebec, particularly with regard to certification, clear labelling, recommendations for PC use depending on exposure situations and information on PC use and its distribution. The effectiveness, thermal comfort, suitability for work and cost of PC also influence its use.

The data show, however, that apple growers also rely on trade know-how in developing and implementing prevention practices that become an integral part of their activities and that they present as complementing their use of PC. These findings suggest that practices that do not comply with recommendations may be seen as adaptations to common microexposure situations, to a lack of information about PC or to rules unsuited to the realities of growers’ work and needs. The prevention practices reveal the growers’ concern about the risks associated with their work.

Thanks to a combined sociological and ergonomic approach, this project produced findings and recommendations firmly rooted in the realities faced by growers. Getting farm workers involved in developing, testing and validating safety rules through trade collectives could yield outcomes that result in better protection against pesticide exposure. If the agricultural community and public health stakeholders join forces, it should be possible to design measures grounded in the realities of growers’ work and social dynamics.