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

Background: As 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. Methods: A 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. Results: The 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 Background: As pesticide use is increasing and proper handling training is lacking, exposure to pesticides an intoxications are an important public health problems among farmers in developing countries. This study describe pesticide use among farmers and compares symptoms of possible acute intoxication and Erythrocyt Acetylcholinesterase(AChE) levels among vegetable farmers with a control group of blood donors in Nepal Methods: A cross-sectional study was carried out among 90 pesticide-exposed farmers and a control group of 9 blood donors. Participants were randomly selected and data were gathered through questionnaires, observatio and blood test. Chi-square test, logistic regression and Student's t-Test were used for data analysis to describ pesticide use and compare symptoms and AChE levels between the two groups. This study was approved by Nepa Health Research Council Results: The majority of pesticides used were WHO class II, classified as moderately hazardous. The mean number of personal protective equipment used by farmers were 2.22 (95% CI: 1.89; 2.54). Out of five hygienic practice asked, farmers followed 3.63 (95% CI: 3.40; 3.86) hygienic practices on the average. Farmers reported mor 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 amon 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). Th risk of a farmer having lower Q level was about 3 times (OR = 2.95; 95% CI: 1.16; 7.51) greater than controls Conclusion: Nepalese farmers exposed to pesticides have significantly more symptoms of possible pesticid intoxication than a control group of healthy individuals. A lower mean haemoglobin-adjusted AChE level was see among farmers compared to the controls. The use of highly toxic pesticides, inadequate use of personal protectiv equipment and poor hygienic practices might explain the reason for symptoms of pesticide intoxication and a lowe AChE level among farmers. Education and information of farmers should be undertaken to remediate these problems.