Developing and Evaluating a Surveillance System Model for Pesticide Related Illness in Illinois

Illinois lacks a pesticide surveillance program that tracks pesticide related illness (PRI) cases to protect its residents and nearly 55,000 annual agricultural workers. The literature shows that while licensed handlers are usually safe, farmworkers continue to be exposed to pesticides and are hospitalized for work-related PRI. There is a need for improving the capture of occupational PRI data. Public health surveillance programs can effectively monitor illnesses and direct informed actions to prevent and protect the public. The goal of this project was to determine what the most efficient surveillance system for monitoring PRI cases in Illinois looks like using a mixed-methods approach. For Aim 1, we used hospital discharge (HD), emergency department (ED), and Illinois Poison Center data to link, count, and characterize PRI cases. A multivariable analysis was also conducted to explore risk factors for PRI. The results from Aim 1 were utilized to construct a potential PRI Surveillance Model which was used to interview key informants (Aim 2) to identify their perceptions of the model, and to interview farmworkers (Aim 3) to elucidate the facilitators and barriers that may exist to reporting PRI in Illinois. This study showed that Illinois lacks adequate resources and databases to capture cases in a manner that helps prevent PRI, and key stakeholders support the need to establish a system that addresses these limitations. These results also highlight that significant differences exist between H2A and established seasonal farmworkers in terms of how they understand PRI, access resources, and experience their work environment. The study’s results were used to refine the proposed PRI system to ensure equitable access for all farmworkers and the public. It also recommends continued research into the differences between farmworkers to better address their unique needs when establishing programs and conducting outreach activities. The next steps include utilizing the results of this study and refined model to propose a policy that implements this program in the State.