Sam Kishore Gnana, Andrade Hira H, Pradhan Lisa, Pradhan Abhishek, Sones Shashi J, Rao Padma G M, Sudhakar Christopher
Department of Pharmacy Practice, SS Cancer Hospital and Research Center, Manipal College of Pharmaceutical Sciences, Manipal, India.
Int Arch Occup Environ Health. 2008 May;81(6):787-95. doi: 10.1007/s00420-007-0263-3. Epub 2007 Oct 26.
Occupational poisoning with pesticides is common in developing countries because farmers are often under trained, illiterate and consider it impractical and expensive to use safety equipment, especially in tropical climates. Greater benefit of education programs on prevention can be obtained if initiated in areas having higher occurrence of poisoning. Hence, the present study evaluated occurrence of poisoning and effectiveness of educational interventions among pesticide handlers in areas having high occurrence of occupational poisoning.
Two villages of Udupi district of South India were identified by spot mapping and targeted for a public education program on safe handling of pesticides, the impact of which was assessed using a knowledge attitude and practice (KAP) questionnaire. Education was provided using a structured individualized training program to 74 pesticide handlers. Three point KAP assessments were carried out at baseline, immediately after training and after 1 month of training. Nonparametric Kruskal-Wallis tests and Friedmann tests were used to compare scores at different time points and between groups.
Occurrence of occupation related poisoning was 33% and common in three villages of the district. The average baseline KAP score of 30.88 +/- 10.33 improved after education significantly (P < 0.001) at first follow-up 45.03 +/- 9.16 and at second follow-up 42.9 +/- 9.54. A decline of score between the first and second follow-up may be attributed to decline in knowledge retention. Demographics like gender, literacy and presence of children affected KAP score and there was no influence of geography, age or frequency of pesticide use.
Educational intervention among pesticide handlers improved the KAP score for safe pesticide handling. We recommend that continuous education and training programs for agricultural workers will promote awareness and minimize the hazards of occupational pesticide exposure.
在发展中国家,农药职业中毒很常见,因为农民往往未受过良好培训、文化程度低,且认为使用安全设备不切实际且成本高昂,尤其是在热带气候地区。如果在中毒发生率较高的地区开展预防教育项目,能获得更大的益处。因此,本研究评估了职业中毒发生率较高地区农药处理人员中毒的发生情况以及教育干预的效果。
通过现场测绘确定了印度南部乌度皮区的两个村庄,并针对其开展了关于安全处理农药的公共教育项目,使用知识、态度和行为(KAP)问卷评估其影响。采用结构化的个性化培训项目对74名农药处理人员进行教育。在基线、培训后立即以及培训后1个月进行三点KAP评估。使用非参数Kruskal-Wallis检验和Friedmann检验比较不同时间点及组间的得分。
该地区三个村庄职业相关中毒的发生率为33%,较为常见。30.88±10.33的平均基线KAP得分在首次随访时显著提高(P<0.001),达到45.03±9.16,第二次随访时为42.9±9.54。首次和第二次随访之间得分的下降可能归因于知识保留率的下降。性别、文化程度和是否有子女等人口统计学因素影响KAP得分,而地理位置、年龄或农药使用频率则没有影响。
对农药处理人员的教育干预提高了安全处理农药的KAP得分。我们建议为农业工人开展持续的教育和培训项目,以提高认识并最大限度地减少职业性农药接触的危害。