Picking Fruit in 106 Degrees in Oregon: How Do Health Centers Step in to Prevent Yet Another Heat-Related Death?

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It’s August -- and it’s hot. A stubborn heatwave has gripped the Pacific Northwest, and the National Weather Service has two weather alerts for the Columbia Gorge region, a scenic rural strip along the Columbia River east of Portland, Oregon. The Dalles, a Wasco county seat, is expected to hit a high of 106 degrees Fahrenheit.

In The Dalles, hundreds of workers awoke at their farm owner-provided housing, ready to head to the orchards for another hot day. Agricultural workers are unlikely to skip work because of a National Weather Service alert. And the extreme heat has been paired with another health danger: wildfire smoke. For the second week in a row, health authorities have issued air quality alerts, heightening the health threats that face agricultural workers when they head to work.

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Heat Advisory Issued by NWS Pendleton (Northeast Oregon and Southeast Washington), alerts.weather.gov [2]

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What can health providers do when extreme heat hits the orchards? When the official advice is to stay indoors and use air conditioning, how do we effectively prepare agricultural workers for a day in the sun? With few alternative employment opportunities, most agricultural workers are unable to avoid the searing heat -- and with low wages and often substandard housing, many come home to a hot house without climate control, further elevating their risk of heat-related illnesses.

Every summer, agricultural workers around the country die completely preventable deaths due to heat. Some are unaware of protective regulations in certain states, others don’t know the signs and symptoms, and still others may not be aware that they are more at risk if they are new outdoor workers, are older, or suffer from chronic conditions.

Just a few days before this latest heat wave, MCN’s Alma Galván, MHC, Senior Program Manager of Environmental and Occupational Health, headed to The Dalles to watch heat stress trainings provided by local health centers at agricultural worker housing facilities, as part of MCN’s Occupational Safety and Health Administration (OSHA) Susan Harwood Training project. Galván was there to monitor the worker trainings for which the CHWs had been trained earlier in the year by MCN [3]. The worker trainings started at 5pm, after workers had returned from picking.

MCN's Alma Galvan, center, worked closely with Next Door CHWs Tona Sanchez and Joel Pelayo.

“Training after the workers return from a long day in the orchards is hard,” Galván admitted. So the CHWs have to get creative. The first training she watched, offered by One Community Health for cherry pickers, was scheduled to kick off a health fair staffed by volunteer clinicians -- physicians, medical assistants, nurses -- and orchestrated by coordinator Alicia Swift to provide a wide range of health screenings and consultations. The clinicians set up their health fair in the common space of the clean and modern worker housing complex -- but before attendees could access the health services, which were provided for free, they first participated in a short training on heat stress prevention.

“They used role playing to show what to do if somebody is showing signs of heat stress in the field,” Galván recounted. They also received small food incentives for their participation. A critical part of reducing heat-related illness is recognizing the signs and symptoms, and helping fellow workers who may be disoriented or unable to recognize the problem on his or her own.

Roughly 40 workers, both men and women, many with their kids in tow, participated in the training, and then headed off to the health fair tables. Screenings and physician advice right outside one’s doorstep is a big motivator, Galván said, as clinics aren’t too close to this rural camp, and workers often have to take time off -- thereby losing wages -- if they wish to head to the doctor. After workers made their way through the tables, the CHWs conducted a post-training evaluation.

A critical part of reducing heat-related illness is recognizing the signs and symptoms, and helping fellow workers who may be disoriented or unable to recognize the problem on his or her own.

The following day, Galván monitored a second heat stress training for cherry pickers conducted by Next Door Inc., another MCN partner in The Dalles. The community housing here had a different feel -- whiteboards outside the housing showed daily chores to keep communal areas like showers and laundry facilities clean, and the surrounding pear orchards were quiet, as the pears weren’t yet ripe -- and Galván was happy to see that, like One Community Health, Next Door Inc.’s CHWs had tailored their training for the cherry pickers. “It was very fun and informative. They really care about the people,” Galván noted. Next Door’s CHWs Tona Sanchez and Joel Pelayo “have been part of the community and doing this work for a very long time, and offered a traditional participatory approach,” explained Galván. Part of that approach were the flyers they posted in surrounding camps ahead of the training, and a door-to-door campaign the day of the training. They offered raffle prizes of insulated water bottles to keep water cool on the hottest days. 

This summer, the project’s train-the-trainer approach has brought up-to-date, in-depth, and relevant training on heat stress to hundreds of workers in a region now experiencing intense heat. Both Next Door, Inc. and One Community Health are wrapping up the busiest time of the year, as the cherry season ends and pear season begins. Many workers will shortly be heading to Washington State, California, and elsewhere for the early fall crops -- armed with more knowledge of how to prevent heat related illness.

“As climate change pushes temperatures up and areas like central Oregon experience even hotter summer temperatures, heat must be recognized as a major safety concern for workers,” Galván concluded. “I am very proud of the partnership that MCN has with Next Door and One Community Health to provide such critical information. Even saving one life makes all the effort worth it.”

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