Abstract
BACKGROUND: Occupational heat-related illness (HRI) is problematic in the United States. Farmworkers are disproportionately affected by HRI compared to other workers. Uncovering barriers that farmworkers face to the prevention of HRI is crucial to reducing HRI-associated morbidity and mortality. This integrative review aimed to understand US farmworkers' barriers to preventing HRI. METHODS: An integrative review occurred following Whittemore and Knafl guidelines. Literature searches occurred on PubMed, Medline, and Agricola. After applying inclusion and exclusion criteria and removing duplicates, nine articles remained for review. RESULTS: There were nine articles in the review. The majority of articles used a convenience sample. In all studies, the populations were farmworkers or agricultural workers. The study designs included cross-sectional, mixed methods, qualitative focus groups, and a longitudinal study. The articles revealed several themes related to prevention barriers: access to prevention, education and training, work culture, and compensation. Farmworkers often lack access to proper prevention measures, education, and training. Work culture and compensation were obstacles to preventing HRI as some workers feel powerless to speak up for themselves, whereas others are tempted to forgo breaks because of the way they are compensated. CONCLUSIONS: This review indicates the need for more research to understand the barriers farmworkers face to HRI prevention. Providing prevention measures without considering obstacles to their use is ineffective in reducing HRI. Because many farmworkers lack oversight and regulation of prevention measures, focusing on barriers and areas over which farmworkers have more control could have a significant impact.