Federal Protections for Farmworker Health in the United States: A Scoping Review of Three Decades of Research

OBJECTIVES: This scoping review characterizes the scope, methods, and framing of empirical research evaluating the Field Sanitation Standard (FSS) and Worker Protection Standard (WPS) of the U.S. Environmental Protection Agency and the U.S. Department of Labor respectively. METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we identified empirical studies (1990-2024) assessing elements of either the FSS or WPS. Two reviewers screened and extracted study characteristics, designs, populations, and regulatory elements. Framing analysis of 1226 segments, identified using a large language model, from the studies' abstracts and introductions examined how authors conceptualized farmworkers' need for protection. RESULTS: Forty studies met the inclusion criteria. Studies concentrated in the Atlantic Southeast, and the vast majority (> 80%) used cross-sectional designs. Most (75%) focused on the WPS, primarily pesticide-safety training, while the FSS was less studied. Ten frames emerged; the most common were behavioral intervention (83%), regulatory inadequacy (75%), and structural vulnerability (65%). CONCLUSIONS: Evaluation of WPS and FSS effectiveness is fragmented: geographically concentrated, episodically timed, and predominantly descriptive. These limitations hinder impact assessment. The 2018 EPA Office of Inspector General recommendation for systematic WPS evaluation remains unmet. Sustained federal investment in rigorous, longitudinal evaluation, covering both the WPS and FSS, is needed to ensure the policies' objectives, the protection of farmworker health, are met.