Pesticide use, erythrocyte acetylcholinesterase level and self-reported acute intoxication symptoms among vegetable farmers in Nepal: a cross-sectional study

Abstract

BackgroundAs pesticide use is increasing and proper handling training is lacking, exposure to pesticides and intoxications are an important public health problems among farmers in developing countries. This study describes pesticide use among farmers and compares symptoms of possible acute intoxication and Erythrocyte Acetylcholinesterase(AChE) levels among vegetable farmers with a control group of blood donors in Nepal.MethodsA cross-sectional study was carried out among 90 pesticide-exposed farmers and a control group of 90 blood donors. Participants were randomly selected and data were gathered through questionnaires, observation and blood test. Chi-square test, logistic regression and Student’s t-test were used for data analysis to describe pesticide use and compare symptoms and AChE levels between the two groups. This study was approved by Nepal Health Research Council.ResultsThe majority of pesticides used were WHO class II, classified as moderately hazardous. The mean numbers of personal protective equipment used by farmers were 2.22 (95% CI: 1.89; 2.54). Out of five hygienic practices asked, farmers followed 3.63 (95% CI: 3.40; 3.86) hygienic practices on the average. Farmers reported more symptoms of possible pesticide intoxication in the past month than did controls, mean 5.47 (95% CI: 4.70; 6.25) versus 2.02 (95% CI: 1.63; 2.40) (p < 0.05). The mean haemoglobin-adjusted AChE(Q) was significantly lower among farmers compared to controls, 28.92 (95% CI: 28.28; 29.56) U/g versus 30.05 (95% CI: 29.51; 30.60) U/g, (p = 0.01). The risk of a farmer having lower Q level was about 3 times (OR = 2.95; 95% CI: 1.16; 7.51) greater than controls.ConclusionNepalese farmers exposed to pesticides have significantly more symptoms of possible pesticide intoxication than a control group of healthy individuals. A lower mean haemoglobin- adjusted AChE level was seen among farmers compared to the controls. The use of highly toxic pesticides, inadequate use of personal protective equipment and poor hygienic practices might explain the reason for symptoms of pesticide intoxication and a lower AChE level among farmers. Education and information of farmers should be undertaken to remediate these problems.

Pesticide Poisoning Among Commercial Vegetable Farmers of Chitwan, Nepal

“…However, a study done in Nepal by Neupane et al 15 reported a higher number of possible symptoms (4.78) of acute intoxication. Another study done in Indonesia by Kishi et al 16 reported that farmers had four signs/symptoms on an average, which is a very high level of intoxication and thereby creates an urgent need of increasing awareness among the commercial farmers.…”

Measurement of Organophosphate Pesticides, Organochlorine Pesticides, and Polycyclic Aromatic Hydrocarbons in Household Dust from Two Rural Villages in Nepal

“…The studies of human exposures to pesticides in Nepal have typically focused on occupational exposures [16,[62][63][64], or cases of pesticide poisoning and acute symptoms of pesticide exposure [65][66][67][68][69]. Studies of residential use of pesticides in Nepal have generally assessed methods for managing sand fly populations to control visceral leishmaniasis [70][71][72][73][74].…”

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“…None of those who protect themselves wear all the personal protection equipment (PPE) normally recommended. Contrarily, Neupane et al (2014) reports that only 13% of farmers did not use any PPE while spraying pesticides in the field. Most farmers use only gloves (13.73%), temporary mufflers (5.66%), hats (0.44%) and boots (0.44%) in addition to their usual farm clothes.…”

“…The gloves are therefore the most widely used personal protection equipment. Neupane et al (2014) found that about 46% of farmers used dust mask to protect against pesticide while spraying in the field and 33% farmers used long legged trousers or pants in Nepal. The percentage of respondents who used glass, gowns, boots and gloves was less than 10% (Neupane and Jørs, 2014).…”

“…Neupane et al (2014) found that about 46% of farmers used dust mask to protect against pesticide while spraying in the field and 33% farmers used long legged trousers or pants in Nepal. The percentage of respondents who used glass, gowns, boots and gloves was less than 10% (Neupane and Jørs, 2014). However, Hinson et al (2016) found that mufflers (29.9%) and gloves (12.3%) were the most widely used personal protection equipment in Benin.…”