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Nafees AA, Ali Y, Sadia A, Shaukat N, Irfan M, Fatmi Z, Azam I, Matteis SD, Burney P, Cullinan P. Assessing the Feasibility of a Multifaceted Intervention Package for Improving Respiratory Health of Textile Workers: Findings From the MultiTex Pilot Study in Karachi, Pakistan. Asia Pac J Public Health 2024; 36:202-209. [PMID: 38247056 DOI: 10.1177/10105395231226273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
We piloted the development and implementation of a multifaceted intervention package for improving respiratory health among textile workers using a pre-post design at six mills in Karachi. The intervention, implemented following a baseline survey (n = 498), included health and safety training of workers and managers, promotion of cotton dust control measures, and the provision of facemasks. Follow-up surveys were conducted at 1, 6, and 12 months post-intervention. Knowledge, attitude, and practice (KAP) scores and respiratory symptoms were assessed through a questionnaire and spirometry was conducted. The intervention was provided to 230 workers and led to an improvement in KAP scores that was more likely among workers with a higher educational status, spinners, smokers, those with a permanent employment status, working in morning shifts, and with ⩾5 years of textile experience. We found the intervention acceptable and feasible in these textile mills henceforth, trials are required to determine its effectiveness.
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Affiliation(s)
- Asaad Ahmed Nafees
- Department of Community Health Sciences, The Aga Khan University, Karachi, Pakistan
- Genomic and Environmental Medicine, National Heart and Lung Institute, Imperial College London, UK
| | - Yousaf Ali
- Department of Community Medicine and Public Health, Khyber Medical College, Peshawar, Pakistan
| | - Afreen Sadia
- Department of Community Health Sciences, The Aga Khan University, Karachi, Pakistan
| | - Natasha Shaukat
- Department of Community Health Sciences, The Aga Khan University, Karachi, Pakistan
| | - Muhammad Irfan
- Department of Pulmonary and Critical Care Medicine, The Aga Khan University, Karachi, Pakistan
| | - Zafar Fatmi
- Department of Community Health Sciences, The Aga Khan University, Karachi, Pakistan
| | - Iqbal Azam
- Department of Community Health Sciences, The Aga Khan University, Karachi, Pakistan
| | - Sara De Matteis
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Peter Burney
- Genomic and Environmental Medicine, National Heart and Lung Institute, Imperial College London, UK
| | - Paul Cullinan
- Genomic and Environmental Medicine, National Heart and Lung Institute, Imperial College London, UK
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The effectiveness of educational interventions aimed at agricultural workers' knowledge, behaviour, and risk perception for reducing the risk of pesticide exposure: a systematic review and meta-analysis. Int Arch Occup Environ Health 2022; 95:1167-1178. [PMID: 35103845 DOI: 10.1007/s00420-022-01838-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 01/12/2022] [Indexed: 11/05/2022]
Abstract
AIM The aim of this study was to determine the effectiveness of educational interventions aimed at agricultural workers' knowledge, behaviour, and risk perception for reducing the risk of pesticide exposure. METHOD All studies published in the English language between the years 2000 and 2020 were screened on relevant databases. The study protocol was registered on PROSPERO. Randomised controlled studies (RCTs) and quasi-experimental studies meeting the inclusion and exclusion criteria according to the PICOS criteria were included. In line with the PRISMA flow diagram, 38 studies were included in the systematic review and meta-analysis. Risk of bias was assessed with the Cochrane risk-of-bias assessment tool. A random-effects model was applied and Hedge's g was used to calculate effect size. FINDINGS Five of the included studies are RCTs, two are cluster RCTs, 17 are quasi-experimental studies with experimental and control groups, and 14 have single-group pretest-posttest study designs. Educational interventions had a large effect on knowledge level (Hedge's g = 0.890), a medium effect on behaviour level (Hedge's g = 0.707), and a small effect on risk perception (Hedge's g = 0.377). No publication bias was detected. The largest effect of educational interventions on both knowledge and behaviour levels belonged to studies grounded on a theoretical basis and carried out between the years 2011 and 2020. CONCLUSION It was determined that educational interventions are an appropriate method for reducing the pesticide exposure risks of agricultural workers. To increase the effectiveness of these interventions, it is recommended that consideration is given to a theoretical basis, the use of multiple education components, and evidence-based practices.
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Staudacher P, Brugger C, Winkler MS, Stamm C, Farnham A, Mubeezi R, Eggen RIL, Günther I. What agro-input dealers know, sell and say to smallholder farmers about pesticides: a mystery shopping and KAP analysis in Uganda. Environ Health 2021; 20:100. [PMID: 34470641 PMCID: PMC8411546 DOI: 10.1186/s12940-021-00775-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 07/26/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Pesticides can have negative effects on human and environmental health, especially when not handled as intended. In many countries, agro-input dealers sell pesticides to smallholder farmers and are supposed to provide recommendations on application and handling. This study investigates the role of agro-input dealers in transmitting safety information from chemical manufacturers to smallholder farmers, assesses the safety of their shops, what products they sell, and how agro-input dealers abide by laws and recommendations on best practices for preventing pesticide risk situations. METHODS Applying a mixed-methods approach, we studied agro-input dealers in Central and Western Uganda. Structured questionnaires were applied to understand agro-input dealers' knowledge, attitude and practices on pesticides (n = 402). Shop layout (n = 392) and sales interaction (n = 236) were assessed through observations. Actual behavior of agro-input dealers when selling pesticides was revealed through mystery shopping with local farmers buying pesticides (n = 94). RESULTS While 97.0% of agro-input dealers considered advising customers their responsibility, only 26.6% of mystery shoppers received any advice from agro-input dealers when buying pesticides. 53.2% of products purchased were officially recommended. Sales interactions focused mainly on product choice and price. Agro-input dealers showed limited understanding of labels and active ingredients. Moreover, 25.0% of shops were selling repackaged products, while 10.5% sold unmarked or unlabeled products. 90.1% of shops were lacking safety equipment. Pesticides of World Health Organization toxicity class I and II were sold most frequently. Awareness of health effects seemed to be high, although agro-input dealers showed incomplete hygiene practices and were lacking infrastructure. One reason for these findings might be that only 55.7% of agro-input dealers held a certificate of competency on safe handling of pesticides and even fewer (5.7%) were able to provide a government-approved up-to-date license. CONCLUSION The combination of interviews, mystery shopping and observations proved to be useful, allowing the comparison of stated and actual behavior. While agro-input dealers want to sell pesticides and provide the corresponding risk advice, their customers might receive neither the appropriate product nor sufficient advice on proper handling. In light of the expected increase in pesticide use, affordable, accessible and repeated pesticide training and shop inspections are indispensable.
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Affiliation(s)
- Philipp Staudacher
- Eawag, Swiss Federal Institute of Aquatic Science and Technology, Überlandstrasse 133, 8600 Dübendorf, Switzerland
- Institute of Biogeochemistry and Pollutant Dynamics, CHN, Universitätsstrasse 16, ETH Zürich, 8092 Zürich, Switzerland
| | - Curdin Brugger
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Mirko S. Winkler
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Christian Stamm
- Eawag, Swiss Federal Institute of Aquatic Science and Technology, Überlandstrasse 133, 8600 Dübendorf, Switzerland
| | - Andrea Farnham
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Ruth Mubeezi
- School of Public Health, Makerere University, Kampala, Uganda
| | - Rik I. L. Eggen
- Eawag, Swiss Federal Institute of Aquatic Science and Technology, Überlandstrasse 133, 8600 Dübendorf, Switzerland
- Institute of Biogeochemistry and Pollutant Dynamics, CHN, Universitätsstrasse 16, ETH Zürich, 8092 Zürich, Switzerland
| | - Isabel Günther
- Development Economics Group & Center for Development and Cooperation (NADEL), ETH Zürich, Clausiusstrasse 37, 8092 Zürich, Switzerland
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Huang Y, Luo X, Liu D, Du S, Yan A, Tang L. Pest control ability, technical guidance, and pesticide overuse: evidence from rice farmers in rural China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:39587-39597. [PMID: 33761074 DOI: 10.1007/s11356-021-13607-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 03/18/2021] [Indexed: 06/12/2023]
Abstract
Pesticide overuse is still prevalent in many developing countries. And improving farmers' pest control ability is considered to be the key to achieve pesticide reduction. Based on the survey data of 822 rice farmers from Hubei, Jiangxi, and Zhejiang provinces in the Yangtze River Basin, we demonstrated the impact of pest control ability and technical guidance on farmers' pesticide overuse. We find that rice farmers' insufficient pest control ability does not necessarily lead to pesticide overuse, which depends on whether there is external technical guidance. The technical guidance of government agrotechnical stations and pesticide retailers can weaken pesticide overuse caused by lack of personal ability. In terms of sample, variable and method substitution, the above estimated results are still robust. In addition, we find that different subjects and links of pesticide technical guidance will bring different impacts. The technical guidance of agrotechnical stations mainly plays a role in the time and type of pesticide application, while the pesticide retailers mainly play a role in the time and dosage of pesticide application. This paper emphasizes that strengthening the guidance and regulation of pesticide technology guidance subject is also an efficient way of pesticide reduction. This will help to improve the effect of agricultural extension and accelerate the realization of pesticide reduction target in China.
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Affiliation(s)
- Yanzhong Huang
- College of Economics and Management, Huazhong Agricultural University, Wuhan, 430070, Hubei, China
- Hubei Rural Development Research Center, Wuhan, 430070, Hubei, China
- Rural Sustainable Development Research Center, Huazhong Agricultural University, Wuhan, 430070, China
| | - Xiaofeng Luo
- College of Economics and Management, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
- Hubei Rural Development Research Center, Wuhan, 430070, Hubei, China.
- Rural Sustainable Development Research Center, Huazhong Agricultural University, Wuhan, 430070, China.
| | - Di Liu
- College of Economics and Management, Huazhong Agricultural University, Wuhan, 430070, Hubei, China
| | - Sanxia Du
- College of Economics and Management, Huazhong Agricultural University, Wuhan, 430070, Hubei, China
| | - Aqian Yan
- College of Economics and Management, Huazhong Agricultural University, Wuhan, 430070, Hubei, China
| | - Lin Tang
- College of Economics and Management, Huazhong Agricultural University, Wuhan, 430070, Hubei, China
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Afshari M, Karimi-Shahanjarini A, Khoshravesh S, Besharati F. Effectiveness of interventions to promote pesticide safety and reduce pesticide exposure in agricultural health studies: A systematic review. PLoS One 2021; 16:e0245766. [PMID: 33497407 PMCID: PMC7837484 DOI: 10.1371/journal.pone.0245766] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 01/08/2021] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE There is a relationship between pesticide exposure and farmworkers' health. Well-conducted evaluations can provide an insight into how to develop and implement more effective interventions to prevent farmers and farmworkers' exposure to pesticides. This review aimed to summarize the literature on the effectiveness of interventions to promote pesticide safety and reduce pesticide exposure among farmers and farmworkers. METHODS A comprehensive search on PubMed, Embase, ISI Web of Science, Scopus, Science Direct, Agricola, NIOSHTIC, and Agris databases was performed to identify relevant studies published from 2000 to 2019. Randomized controlled trials (RCTs) and quasi-experimental studies assessing the effectiveness of interventions on a variety of outcomes related to pesticide exposure were considered. The searches were restricted to articles written in English. The methodological quality of included reviews was appraised using the Effective Public Health Practice Project quality assessment tool (EPHPP). RESULTS The initial search led to 47912 records, 31 studies of which including nine RCTs and twenty-two quasi-experimental studies met the criteria. The majority of the included studies focused on the educational/ behavioral approach. The studies that applied this approach were effective in improving the participants' knowledge and attitude; however, these interventions were less effective in terms of making changes in participants' behaviors and their risk of exposure to toxic pesticides. Multifaceted interventions were moderately effective in terms of improving farmers' and farmworkers' behaviors and reduction in exposure to toxic pesticides. We did not find any studies that had evaluated the effectiveness of engineering/technological, and legislation/enforcement interventions. CONCLUSIONS Although the majority of studies were based on an educational/behavioral approach and did not assess the effect of interventions on objective measures, the results of this review highlight the significant effectiveness of educational programs and some potential key elements of these interventions. These findings may inform policymakers to develop interventions to reduce pesticide exposure among farmers and farmworkers.
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Affiliation(s)
- Maryam Afshari
- Department of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Akram Karimi-Shahanjarini
- Department of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Sahar Khoshravesh
- Department of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Fereshteh Besharati
- Department of Nursing, Zeynab (P.B.U.H) School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
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Koju P, Shakya PR, Shrestha A, Karmacharya BM, Shrestha S, Jaacks LM. Pilot Educational Intervention to Promote Safe Pesticide Use Practices Among Farmworkers in Nepal. Ann Work Expo Health 2020; 64:866-875. [PMID: 32491155 DOI: 10.1093/annweh/wxaa054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 03/18/2020] [Accepted: 05/12/2020] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES The misuse of pesticides among farmworkers in Nepal is commonplace. To address this, we implemented a pilot educational intervention (three modules delivered over 3 days and lasting approximately 3 h each) in Kavre District of Nepal. Modules included: (i) health and environmental effects of pesticides, (ii) use of personal protective equipment, and (iii) label literacy and behavioral factors that influence pesticide exposure. In addition, 10 posters with key messages from each of the modules were hung throughout communities. METHODS Surveys were administered to cross-sectional convenience samples of farmworkers at baseline (n = 106) and 1 year later (n = 98). Practices relating to pesticides at baseline and endline were compared using multivariable logistic regression to adjust for differences in demographic and socioeconomic characteristics between the samples. RESULTS Compared with the baseline sample, farmworkers in the endline sample were significantly more likely to report: getting information regarding the amount of pesticides to use from experts or pesticide labels (versus personal judgment); wearing gloves while mixing pesticides; wearing boots while working in the field; using personal hygiene practices after handling pesticides such as bathing or washing hands and feet; changing clothes after handling pesticides; checking the wind direction before spraying; and delaying entry for a longer period of time after spraying. CONCLUSIONS These results suggest that a simple educational intervention can improve pesticide handling practices among farmworkers in Nepal. Future research should explore the impact of such interventions on pesticide exposure levels and health outcomes, and the potential to scale up these programs nationally.
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Affiliation(s)
- Pramesh Koju
- Department of Community Programs, Dhulikhel Hospital-Kathmandu University Hospital, Dhulikhel, Kavrepalanchok, Nepal
| | - Prabin R Shakya
- Department of Community Programs, Dhulikhel Hospital-Kathmandu University Hospital, Dhulikhel, Kavrepalanchok, Nepal
| | - Archana Shrestha
- Department of Community Programs, Dhulikhel Hospital-Kathmandu University Hospital, Dhulikhel, Kavrepalanchok, Nepal
| | - Biraj M Karmacharya
- Department of Community Programs, Dhulikhel Hospital-Kathmandu University Hospital, Dhulikhel, Kavrepalanchok, Nepal
| | - Sudip Shrestha
- Department of Community Programs, Dhulikhel Hospital-Kathmandu University Hospital, Dhulikhel, Kavrepalanchok, Nepal
| | - Lindsay M Jaacks
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Sibani C, Jessen KK, Tekin B, Nabankema V, Jørs E. Effects of Teaching Health Care Workers on Diagnosis and Treatment of Pesticide Poisonings in Uganda. ENVIRONMENTAL HEALTH INSIGHTS 2017; 11:1178630217726778. [PMID: 28890656 PMCID: PMC5580847 DOI: 10.1177/1178630217726778] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 07/17/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Acute pesticide poisoning in developing countries is a considerable problem, requiring diagnosis and treatment. This study describes how training of health care workers in Uganda affects their ability to diagnose and manage acute pesticide poisoning. METHOD A postintervention cross-sectional study was conducted using a standardized questionnaire. A total of 326 health care workers in Uganda were interviewed on knowledge and handling of acute pesticide poisoning. Of those, 173 health care workers had received training, whereas 153 untrained health care workers from neighboring regions served as controls. RESULTS Trained health care workers scored higher on knowledge of pesticide toxicity and handling of acute pesticide poisoning. Stratification by sex, profession, experience, and health center level did not have any influence on the outcome. CONCLUSIONS Training health care workers can improve their knowledge and treatment of pesticide poisonings. Knowledge of the subject is still insufficient among health care workers and further training is needed.
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Affiliation(s)
- Claudia Sibani
- Research Unit of Occupational and Environmental Medicine, University of Southern Denmark, Odense, Denmark
| | - Kristian Kjaer Jessen
- Research Unit of Occupational and Environmental Medicine, University of Southern Denmark, Odense, Denmark
| | - Bircan Tekin
- Research Unit of Occupational and Environmental Medicine, University of Southern Denmark, Odense, Denmark
| | - Victoria Nabankema
- Uganda National Association of Community and Occupational Health (UNACOH), Kampala, Uganda
| | - Erik Jørs
- Department of Occupational and Environmental Medicine, Odense University Hospital, Odense, Denmark
- NGO Dialogos, Nørrebrogade, Copenhagen, Denmark
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