Pesticide risk reduction program to improve protective behavior and reduce health risk of pesticide use among rice farmers in Kong Krailat district, Sukhothai province

Abstract

The problem of inappropriate pesticide usage is an important concern for public health and occupational authorities in Thailand. To date there have been few intervention studies aimed at improving pesticide-related protective behavior and reducing health risk. In this quasi-experimental study, the researcher conducted a pesticide risk reduction intervention program. The objectives were to improve knowledge, attitude, and protective behavior, and to reduce health risk of pesticide use, among 182 rice farmers from December 2011 to June 2012 in Sukhothai province, Thailand. The intervention group, comprising 91 farmers, received 1-month intervention program. Outcomes were measured before intervention (baseline), and at 1 and 4 months after intervention. The effects of intervention were evaluated with difference-of-difference analysis, with normal and binomial distributions for continuous and dichotomous outcomes, respectively. The link function was identity in all difference-in-difference models, which gave modeled intervention effects and statistical significance tests of those effects, at each of the 2 follow-up times. (The intervention effect is defined as the baseline-to-follow-up difference in outcome in the intervention group minus the corresponding difference in the control group.) All 182 participants had attended all follow-up times. After adjusted mean difference, the intervention program improved the knowledge by a mean score 4.2 ( 95%CI 3.7–4.8; p<0.001) one month after the intervention and by a mean score of 3.5 (95%CI 2.8–4.3; p<0.001) 4 months later, attitude by a mean score of 8.9 (95%CI 6.5-11.4; p<0.001) one month after the intervention and by a mean score of 13.2 (95%CI 8.9–17.5; p<0.001) 4 months later, protective behavior by a mean score of 8.6 (95%CI 7.4–9.9; p<0.001) one month after the intervention and by a mean score of 6.2 (95%CI 3.9–8.5; p<0.001) 4 months later, reduced the prevalence of unsafe serum cholinesterase level after adjusted percent-points by 56.2 percent-points (95%CI −70.8 to −41.7; p<0.001) one month after the intervention and by 44.6 percent-points (95%CI −64.5 to −24.6; p<0.001) 4 months later, reduce prevalence of neuromuscular symptom after adjusted percent-points by 27.8 percent-points (95%CI −43.8 to −11.8; p=0.001) one month after the intervention and by 25.0 percent-points (95%CI −45.7 to −4.2; p=0.019) 4 months later, respiratory symptom after adjusted percent-points by 25.4 percent-points (95%CI −41.9 to −8.9; p=0.003) one month after the intervention, eyes symptom after adjusted percent-points by 34.3 percent-points (95%CI −53.6 to −15.1; p=0.001) one month after the intervention Thus, multidimensional of risk such using some of the data from baseline to formative self or cultural background in the intervention area, social learning such colleague workers and concern on risk communication factors should be considered for implementation to improve the risk perception and safe use of pesticide in other rice farm areas. The success of program depends on the risk communication factors, including audiences, medium, messages, and messengers.