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My arms were hurting.When the plants are wet, they are even heavier, and its harder to carry them and lift them.[173] Musculoskeletal disorders are usually caused by an accumulation of microtrauma without sufficient time to recover.[174] According to DOL, musculoskeletal disorders account for nearly one in four nonfatal agricultural occupational illnesses and injuries in the United States among adult and child farmworkers.[175] A 2009 review of studies related to musculoskeletal disorders among farmworkers in the eastern United States found that farmworkers were most affected in the neck, shoulders, and upper extremities.[176] Public health research among farmworkers has found that although treating repetitive motion injuries typically requires rest, as well as anti-inflammatories, splinting, physical therapy, and rehabilitation, farmworkers are under pressure to keep working at the same rate and often lack access to medical care.[177] NIOSH has found that children are especially vulnerable to repetitive motion injuries because their bodies are still developing.[178] According to public health studies of farmers and farmworkers, the impacts of repetitive strain injuries may be long-lasting and result in long-term health consequences including chronic pain and arthritis.[179] Lack of Personal Protective Equipment Very few of the children interviewed by Human Rights Watch for this report were given any kind of personal protective equipment by their employers to protect them from nicotine poisoning or pesticide exposure

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