DOI: https://doi.org/10.21203/rs.3.rs-1561171/v1
Farmers’ behavior in pesticide use is crucial for promoting safety in agriculture, yet little information exists in the literature with regard to greenhouse farmers. This work studied greenhouse farmers’ health symptoms from exposure to pesticides, behavior in using personal protective equipment (PPE), and explained behavior based on risk attitudes, knowledge of hazards of pesticide use, and experience in pesticide handling in Khuzestan province, Iran. Dizziness while preparing the solution and spraying was the most common symptom from pesticide exposure. PPE was used occasionally, most commonly the simple facemask. Most farmers had negative attitudes towards risks of pesticide use, but showed poor knowledge of pesticide risks and high experience of pesticide poisoning when working in the greenhouse. Based on structural equation modelling, the variables of attitude towards pesticide risks, knowledge of pesticides hazards, and experience of pesticide poisoning accounted for 84% of variability of greenhouse farmers’ behavior in PPE use during pesticide use. Knowledge of pesticide risks shaped farmers’ attitudes towards pesticide risk and attitudes towards pesticide risk had the maximum impact on safety behavior in PPE use. Training courses on the health risks posed by pesticide to human are necessary to improve safety behavior of greenhouse farmers.
Exposure to pesticides is a major threat for the health of farmers and farm workers around the world (Damalas and Koutroubas, 2016). This situation is often observed in countries of the developing world (Khan and Damalas, 2015; Saeed et al., 2017; Marete et al., 2021) where patterns of pesticide use for protecting crops have been increased. According to the World Health Organization (WHO), poisoning by pesticides is a public health problem around the globe (Damalas and Koutroubas, 2016), with known acute effects on human health by several pesticide substances. Studies in countries all over the world have noted respiratory symptoms from occupational exposure to pesticides (Quansah et al. 2019; Shrestha et al. 2019, 2021; Thammachai et al., 2022).
Farmers’ knowledge, beliefs, and attitudes have been shown to underpin occupational exposure from pesticide use in developing countries (Fan et al., 2015; Bhandari et al. 2018; Gesesew et al., 2016; Damalas and Khan, 2017; Bagheri et al., 2018). Significant proportions of farmers have shown unsafe or potentially unsafe behaviour in pesticide handling and in the use of personal protective equipment (PPE) (Rezaei et al., 2017; Bagheri et al., 2018; Bondori et al., 2018; Damalas et al., 2019). As a result, ecological and human health concerns from the use of pesticides in cropland are topical in the areas of daily practice of farmers, the research community, and the policy formation (Huang et al., 2020; Schreinemachers et al., 2020), especially in the developing countries where there are weak regulations of pesticide use. For example, experimental evidence has shown that high levels of knowledge about application of pesticides does not always translate into safe practices by farmers, often leading to harmful health effects (Fan et al., 2015; Bagheri et al., 2018; Sharafi et al., 2018).
Crop production in greenhouse farms has been increased globally, in an effort to increase food security for the population growth and mitigate the potential impact of climate change. Therefore, the number of greenhouse farmers and farm workers has increased. In greenhouse farms, pesticide exposure and human health effects are expected to be high because of unfavorable environmental conditions in the greenhouse compared with open fields (Jurewicz et al. 2007; Bretveld et al. 2008). The increased possibility of exposure to pesticides in the greenhouse farms calls for interventions to reduce risk factors in these environments (Amoatey et al., 2020). However, most previous works have dealt with pesticide exposure and resultant health effects of farmers in open fields (Damalas and Eleftherohorinos 2011; Mrema et al. 2017; Sun et al. 2019), while the pesticide exposure scenario in greenhouses is currently not well characterized to successfully implement exposure mitigating strategies. The aim of the current work was to study farmers’ health symptoms from exposure to pesticides, behavior in using PPE, and to explain behavior based on risk attitudes, knowledge of hazards of pesticide use, and experience in pesticide handling in Khuzestan province, Iran. The theoretical framework of the study (Fig. 1) considered the following hypotheses: H1: Greenhouse farmers’ attitudes towards pesticide risks affect PPE use behaviors, H2: Greenhouse farmers’ knowledge of pesticide risks affects PPE use behaviors, H3: Greenhouse farmers’ knowledge of pesticide risks affects attitudes towards pesticide risks, and H4: Greenhouse farmers’ experience of pesticide poisoning affects PPE use behaviors.
The study involved greenhouse farmers in Khuzestan province located in the southwest of Iran between 47° 41' and 51° 39' E and between 29° 58' and 33° 04' N. Khuzestan is located on the shores of the Persian Gulf and is considered the centre of Iran’s oil and gas production. The province has flat plains and is located on the land route between Iraq and Turkey. Khuzestan is one of the important agricultural hubs in Iran. The distribution of pesticides in this province is relatively high, so that after Mazandaran, Fars, and Golestan is in the fourth place in the country (Hosseinzad et al., 2010). The average rainfall in Khuzestan is 265.5 mm per year. Khuzestan province, due to the existence of lands fertile and susceptible with an area of 1.2 million hectares of irrigated and rain-fed lands prone to agriculture, has been able to obtain first to third ranks in the production of strategic products such as wheat, barley, rice and dates. In addition, other products like corn, sugarcane, orange, pomegranate, rapeseed, alfalfa, tomato, cucumber, eggplant, pepper, watermelon, and melon are produced.
The target population of the study included all active greenhouse farmers in Khuzestan province (N = 90). Using Krejcie and Morgan (1970) sampling table at 95% confidence level, the sample size was calculated to 80 farmers (n = 80). Sampling was done by random method. After a literature review, field visits, and consultation with agricultural experts, a questionnaire was developed as data collection tool. The research tool was consisted of five sections. In addition to demographic characteristics, safety behavior (9 items), attitude towards pesticide risk (7 items), knowledge of pesticide risks (8 items), and experienced poisoning symptoms (7 items) were the components of the questionnaire. Except for socio-economic variables, items related to research components were examined on a 5-point Likert scale (from very low = 1 to very high = 5). The content validity of the questionnaire was assessed by a panel of university professors.
After completing the questionnaires, the collected data were coded. The SPSSv22 software and the smart PLS2 were used for data analysis. Descriptive and inferential statistics were used to describe the data. In the descriptive analysis, frequency distribution statistics, percentage, maximum, minimum, mean and standard deviation were used to summarize the data. The interval standard deviation from mean (ISDM) was used to classify the respondents in terms of knowledge, attitude and safety behaviors. In this method, greenhouse farmers were divided into four groups according to the studied variables as follows:
A = Weak/negative: Min ≤ A < Mean - SD
B = Relatively weak/negative: Mean - SD ≤ B < Mean
C = Relatively good/positive: Mean ≤ C < Mean + SD
D = Good/positive: Mean + SD ≤ D < Max
Where Min = the minimum score, Max = the maximum score, Mean = the mean score, and SD = standard deviation.
In the inferential analysis, the mean difference, correlation and structural equation modelling (path analysis) tests were used to assess the effect of independent variables on the dependent variable. Cronbach’s alpha coefficient was used to assess the reliability of the research instrument. The average variance extracted (AVE) was calculated to determine the validity of the construct. According to Fornell and Larcker (1981), a value above 0.5 is appropriate for AVE. In addition, in determining the reliability of the model, a composite reliability index (CR) above 0.6 is accepted, which indicates the degree of control of measurement errors in the structural equation modelling (Hulland, 1999). The goodness of fit GOF index is used to check the overall fit of the model. The GOF is a compromise between the quality of the structural model and the measurement model. Three values of 0.01, 0.25, and 0.36 have been introduced as weak, medium, and strong values for GOF (Wetzels et al., 2009). The calculated GOF value is 0.59, which indicates a strong overall fit of the model.
The average age of the respondents was 38 (20–65) years (data not shown). More than half (52.5%) of them had other jobs besides greenhouse keeping. Concerning education, 10% had primary and secondary, 27.5% had high school education, and 62.5% were graduated universities. Their average farming experience was 18 (4–42) years. On average, they had five years of greenhouse farming experience.
As shown in Table 1, farmers had moderate attitudes towards risks of pesticide use in the greenhouse. The item "food security is more important than productivity and profitability" was the first rank and the item "the use of pesticides in agriculture kills beneficial insects on the farm level" placed in the lowest rank of the respondents.
| Statement | Mean | SD |
|---|---|---|
| Food security is more important than high productivity and profitability | 2.69 | 1.41 |
| Improper use of pesticides in greenhouses endangers domestic and wild animals. | 2.34 | 1.39 |
| Pesticides use in greenhouses pollutes surface and groundwater | 2.31 | 1.22 |
| Pesticides use in greenhouses endangers human health | 2.30 | 1.23 |
| Excessive use of pesticides causes incurable diseases and cancers | 2.28 | 1.34 |
| Pesticides use in greenhouses causes environmental degradation | 2.25 | 1.22 |
| Pesticides in greenhouses kill beneficial insects on the farm | 2.05 | 1.32 |
| Mean scores ranging from 1 = totally disagree to 5 = fully agree | ||
Concerning knowledge of pesticide risks, the item “when handling pesticides, I consider safety and health conditions” (mean = 3.13, SD = 1.53) placed in the highest rank and the item “continuous spraying increases pesticide costs and reduces production and income” placed in lowest rank of greenhouse farmers’ knowledge, respectively (Table 2).
| Statement | Mean | SD |
|---|---|---|
| When handling pesticides, I consider safety and health conditions | 3.13 | 1.53 |
| I avoid spraying pesticides on beneficial insects | 2.90 | 1.48 |
| I read the pesticide instructions and label before spraying | 2.78 | 1.43 |
| Humans and animals should not be exposed to pesticides when spraying | 2.86 | 1.61 |
| Pesticides and their residues should be avoided in water sources | 2.73 | 1.49 |
| I am aware of the ban on the use of some pesticides | 2.65 | 1.54 |
| Excessive use of pesticides in current years has made pests resistant and increased pesticide use | 2.30 | 1.47 |
| Continuous spraying increases pesticide costs and reduces production and income | 2.29 | 1.46 |
| Mean scores ranging from 1 = totally disagree to 5 = fully agree. | ||
Greenhouse farmers’ behaviors regarding the use of PPE when handling pesticides in greenhouses was studied with nine items. In general, the use of PPE was moderate. As Table 3 shows, the highest use of PPE is related to the use of masks, followed by the special clothes and the use of long-sleeved shirts, respectively.
| Personal protective equipment | Mean | SD |
|---|---|---|
| Mask | 2.95 | 1.33 |
| Spray clothes | 2.88 | 1.22 |
| Long sleeve shirts | 2.88 | 1.40 |
| Long pants | 2.65 | 1.35 |
| Boot | 2.43 | 1.45 |
| Gloves | 2.34 | 1.46 |
| Glasses or eye protection cloth | 2.31 | 1.42 |
| Hat | 2.28 | 1.42 |
| Wipes to protect the mouth and face | 2.08 | 1.55 |
| Mean scores ranging from 1 = never used to 5 = always used | ||
The result of ISDM showed that 35% of the respondents had positive attitudes and knowledge and 33.8% of them had proper behavior during pesticide handling (Table 4).
| Level | Attitudes | Knowledge | Behavior | |||
|---|---|---|---|---|---|---|
| FQ | % | FQ | % | FQ | % | |
| Positive | 12 | 15 | 16 | 20 | 16 | 20 |
| Relatively positive | 16 | 20 | 12 | 15 | 11 | 13.8 |
| Relatively negative | 48 | 60 | 42 | 52.5 | 49 | 61.2 |
| Negative | 4 | 5 | 10 | 12.5 | 4 | 5 |
| FQ: frequency | ||||||
Greenhouse farmers experienced low to moderate poisoning symptoms during pesticides handling in greenhouses. The most poisoning symptom was “dizziness” followed by “skin itching” and “stomach ache”. The lowest symptom was blurred vision” (Table 5).
| Symptoms | Mean | SD |
|---|---|---|
| Dizziness while preparing the solution and spraying | 2.59 | 1.68 |
| Skin itching | 2.50 | 1.44 |
| Stomach ache | 2.41 | 1.50 |
| Eye irritation | 2.39 | 1.43 |
| Vomit | 2.20 | 1.36 |
| Diarrhea | 2.16 | 1.54 |
| Blurred vision | 2.09 | 1.39 |
| Mean scores ranging from 1 = never to 5 = always. | ||
Significant correlations were found between greenhouse farmers’ safety behavior and attitudes, knowledge, poisoning symptoms experienced, information sources, work force number and distance from greenhouse to pesticide retail. Participants with proper attitudes, knowledge and more poisoning symptoms experience dealt better with pesticides and more used PPE. Accessibility was another variable correlated with their behavior so that the more distance from pesticide retail the more safety behaviors (Table 6).
| Variable | r | P value |
|---|---|---|
| Attitudes towards pesticide risks | 0.872** | 0.000 |
| Knowledge of pesticide risks | 0.831** | 0.000 |
| Information sources | 0.793** | 0.000 |
| Poisoning symptoms | 0.835** | 0.000 |
| Work force numbers | 0.229* | 0.041 |
| Distance from pesticide retailers | 0.284* | 0.011 |
| ** Significant at P < 0.01; * significant at P < 0.01. | ||
Structural equation modelling was used to identify determinants of PPE use behaviors by greenhouse farmers during handling pesticides. The model showed acceptable values of coefficients mentioned (Table 7), indicating appropriate reliability and validity of the research questions.
| Variable | AVE | CR | Cronbach’s alpha | AVE | GOF |
|---|---|---|---|---|---|
| Attitudes | 0.59 | 0.90 | 0.88 | ||
| Knowledge | 0.52 | 0.89 | 0.87 | 0.59 | 0.59 |
| Behavior in PPE use | 0.65 | 0.92 | 0.90 | ||
| Poisoning experience | 0.63 | 0.94 | 0.92 | ||
| AVE: average variance extracted; CR: composite reliability; GOF: goodness of fit. | |||||
| Dependent variable | Independent variable | Direct effect | t-value | Indirect effect | Total effect | R2 |
|---|---|---|---|---|---|---|
| PPE use behavior | Knowledge | 0.28 | 4.82** | 0.30 | 0.58 | 0.84 |
| Attitudes | 0.50 | 7.84** | - | 0.50 | ||
| Poisoning symptoms | 0.25 | 3.36** | - | 0.25 | ||
| Attitudes | Knowledge | 0.60 | 7.75** | - | 0.60 | 0.36 |
Table 8 indicates the direct effect of attitude on greenhouse farmers’ behavior towards the PPE use. With a coefficient of 0.50 (t = 7.78) at a confidence level of 99% the effect was positive and significant. According to these results, the stronger the attitude of greenhouse farmers towards pesticides risks, the more frequent use of PPE during handling pesticides. The direct effect of greenhouse farmers’ knowledge of pesticide risks on the behavior of PPE use was estimated with a coefficient of 0.24 (t = 4.82) at a confidence level of 99% confidence, which is positive and significant. Accordingly, high knowledge of pesticide risks by greenhouse farmers indicated more use of PPE during pesticide handling. The direct effect of poisoning symptoms on the behavior of using PPE was estimated with a coefficient of 0.24, which was positive and significant at 99% confidence level (t = 3.36). Accordingly, frequent symptoms of poisoning by greenhouse farmers indicated more use of PPE. The direct effect of knowledge on the attitude of greenhouse farmers was estimated with a coefficient of 0.60, which was positive and significant at 99% level with t = 7.75. According to these results, high knowledge of pesticides hazards by greenhouse farmers indicated stronger attitudes towards the risk of using pesticides. According to the findings depicted in Table 8, the most important variables affecting the safety behavior of greenhouse farmers during handling pesticides attitude followed by knowledge and poisoning symptoms. These three variables explained 84% of the variance greenhouse farmers’ behaviors towards the use of PPE. A fitted model of the path coefficient of greenhouse farmers’ behavior in the use of PPE is illustrated in Fig. 2.
Millions of litres of pesticides are used annually in the world. Currently more than 300 hazardous chemical compounds including various chemical fertilizers that are used for soil fertility as well as various pesticides for the control of pests, diseases, and weeds in the agricultural land (Bondori et al., 2016). Dealing with these essentially toxic chemicals, including their preparation and spraying, poses great risks to farmers who are exposed to these hazardous chemicals (Baldi et al., 2012; Bagheri et al., 2019). Some experts believe that the first step for reducing pesticides risks to the farmers is to conduct research on farmers’ attitudes and behaviors about pesticides in agriculture (Koh and Jeyaratnam, 1996). Understanding farmers’ behavior in pesticide handling is crucial for promoting safety in agriculture, yet little information exists in the literature with regard to greenhouse farmers. From this point of view, the current study adds new knowledge to the area of farmers’ occupational exposure to pesticides and safety behavior during pesticide handling, focusing on greenhouse farmers. Findings could be useful for extension services to shape appropriate programs for farmers’ training on pesticide use.
The majority of the greenhouse farmers in the study had relatively weak to moderate behavior in PPE use. It was found that PPE was used occasionally, most commonly the simple facemask. Previous studies also showed similar results concerning farmers’ safety behavior during spraying and preparation of pesticides (Yassin et al., 2002; Aghili-Nejad et al., 2005; Recena et al., 2006; Atreya, 2007; Ghasemi and Karami, 2009; Golzardi et al., 2011; Omari, 2014; Weng et al., 2015; Damalas and Abdollahzadeh, 2016). However, other studies (Gün and Kan, 2009; Gaber and Abdul-Latif, 2012; Al-Zadjali et al., 2013; Karunamoorthi and Yirgalem, 2013) showed moderate to good use of PPE by farmers. Some researchers believe that misconceptions can seriously affect farmers’ behavior to protect themselves from pesticide risks (Salameh et al., 2003; Ghasemi and Karami, 2009). PPE use in pesticide handling can be influenced by several factors, such as demographics, farm structure, behavioral factors, and environmental factors (Sapbamrer and Thammachai, 2020). For example, previous research showed that perception of pesticides being hazardous substances, upper secondary education, previous training on pesticide use, and farm size under cultivation predicted behavior in PPE use (Damalas and Abdollahzadeh, 2016; Sookhtanlou and Allahyari, 2021). Therefore, life-long education programs are necessary for changing wrong perceptions and behavior of pesticide handlers.
According to the findings, 25% of the farmers had moderate levels of knowledge about the risks of pesticides. This finding is consistent with the findings of some previous studies (Aghili-Nejad et al., 2007; Chen et al., 2013; Mohanty et al., 2013). In particular, improving farmers’ knowledge of pesticide risks was found to reduce pesticide use by 10–15% (Chen et al., 2013). Moreover, 35% of farmers had a moderate to strong attitude towards pesticide risks. Farmers’ proper attitude can be effective in guiding them to perform safety behavior (Nazarian et al., 2009). Some studies showed that farmers’ attitudes toward pesticide risks are negative (Ghasemi and Karami, 2009; Golzardi et al., 2011). Other studies have shown that farmers’ attitudes towards pesticide risks are moderate to positive (Nazarian et al., 2009). Education level played an important role in raising awareness about the hazards of pesticides (Karunamoorthi and Yirgalem, 2013). Nevertheless, findings from Egypt showed that the level of education did not alter the safety behavior of farmers (Gaber and Abdul-Latif 2012). Therefore, it is necessary to pay more attention to raising the level of knowledge of pesticide risks in preparing extension education programs. In the current study, knowledge of pesticide risks shaped farmers’ attitudes towards pesticide risk and attitudes towards pesticide risks had the maximum impact on safety behavior in PPE use. Therefore, knowledge of pesticide risks is necessary for improving farmers’ safety behavior. Furthermore, attitude is a main component of human behavior. Farmers’ attitudes towards pesticide risks were found to have a positive and significant relationship with safety behaviors of farmers’ use of PPE, which is in line with previous studies (Golzardi et al., 2011; Ghasemi and Karami, 2009; Nazarian et al., 2009).
Farmers’ knowledge of pesticide risks was significantly correlated with safety behaviors in the use of PPE. A significant relationship was found between farmers’ information source and their safety behavior. Communicating with agricultural promoters, reading specialized journals and the like can be effective by providing the necessary training to farmers for improving their safety behavior. Poisoning of agricultural workers with pesticides, especially in developing countries, is one of the most common occupational hazards related to the use of pesticides (Golzardi et al., 2011; Ghasemi and Karami, 2009). According to the findings of this study, a significant relationship was found between the history of poisoning and the behavior of farmers’ PPE, which is consistent with the findings of previous studies (Gomez et al., 1998; Baldi et al., 2012). Previous research showed that the variable episode of intoxication in the past exerted the strongest positive influence on PPE use (Damalas and Abdollahzadeh, 2016).
The current study adds new knowledge to the area of farmers’ occupational exposure to pesticides and safety behavior in pesticide handling, focusing on greenhouse farmers. The majority of the greenhouse farmers in the study had relatively weak to moderate behavior in PPE use. It was found that PPE was used occasionally, most commonly the simple facemask. Knowledge of pesticide risks shaped farmers’ attitudes towards pesticide risk and attitudes towards pesticide risk had the maximum impact on safety behavior in PPE use. Training courses on the health risks posed by pesticides to humans are necessary to improve safety behaviour of greenhouse farmers.
Funding. This study received no funding.
Conflict of interest. The authors declare that they have no conflict of interest.
Availability of data Available on reasonable request.
Code availability. Not applicable
Ethics approval. A research article following the ethical standard of the institution.
Consent to participate. Not applicable.
Consent for publication. Not applicable.
Authors’ contributions. Ziba Shirzadi collected field data, conducted statistical analysis of data, and wrote the first draft in Persian language; Asghar Bagheri conceptualized the study, supervised the methodology, validated the data, and wrote the original draft in English language; Abolmohammad Bondori and Ali-Akbar Shokohian conducted statistical analysis of data and interpreted the results; Christos A. Damalas validated the data, reviewed and edited the final draft. All authors read and approved the final manuscript.