Occupational Health Hazards of Pesticides Use among Commercial Vegetable Farmers of Kirtipur Municipality, Kathmandu

Background: Occupational health and safety are the integral components of the general concepts of health. In Nepalese context, misuse of pesticides have been observed and practiced in several ways. Nepalese farmers use too much pesticide than needed with too little protection when using pesticides due to which many accidental poisonings occur annually. This study aims to assess the occupational health hazards related to pesticide use among commercial vegetable farmers of Kirtipur Municipality, Kathmandu. Methodology: A community-based cross-sectional study was conducted among 107 randomly selected commercial vegetable farmers in Kirtipur Municipality of Kathmandu by using semi-structured questionnaire. Data were collected using face to face interview method. The questionnaire included socio-demographic characters, pesticide use practices, storage and disposal techniques and health effects among the farmers. Data were entered in Epidata and then analyzed in SPSS version 21. Frequency, percentage, mean, and standard deviation were calculated to measure the practice of pesticide use and occupational health hazards related to pesticide use among farmers. Result: The study is comprised of 52% male and 48% female. About 89% of farmers were wearing Personal Protective Equipment (PPE) during spraying of pesticides. Maximum numbers of farmers changed clothes and took a bath right after the application of pesticide i.e. 87% and 88% respectively. Almost half of the vegetable farmers (45.1%) used burn method for disposal of empty pesticide containers. However, 45.6% of the respondents experienced health problems within 48 hours of pesticide application. Conclusion: The study concluded that almost half of the pesticide users had shown various symptoms of health hazards. Unsafe equipment and condition, inadequate training, limited availability and use of PPE all contributed to the health hazards of pesticide users.


Introduction
The general health of the people is related with occupation in which they are engaged.Occupational health and safety are the integral components of the general concepts of health.The World Health Organization Municipality, Kathmandu, however, are still involved in agriculture.Furthermore, very limited studies have been performed among the commercial farmers from Kathmandu on occupational health hazards and pesticides.Therefore, this research aims to identify the various occupational health hazards related to pesticide use among commercial vegetable farmers of Kirtipur Municipality, Kathmandu.

Methodology
The community based Cross Sectional Study was conducted among the commercial vegetable farmers who were registered in agriculture department of Kirtipur municipality, Kathmandu.The total 107 samples were taken and it was calculated using 50% prevalence with confidence limit of 95% and 10% error using the formula: n = [Z 2 x (p) x (1-p)]/e 2  (1) Out of 10 wards in Kirtipur Municipality, two wards were selected purposively as they were the major production areas of vegetables and were able to fulfill the market demands of local areas of Kirtipur municipality through its production.The total number of commercial vegetable farmers from the selected wards were 629, which was obtained from agriculture sectors records, for the sampling frame.Then, Probability Proportional to Size (PPS) was used to allocate the required number of sample farmers from each wards and farmers were randomly selected through systematic random sampling method from the list available there.Those farmers living in the ward for at least one year and had handled the pesticides, and were willing to participate were included in the study.The data was collected using pre-tested semi-structured questionnaire, which was translated in Nepali language during interview.Face to face interview technique and pictograms stated in pesticide packets, bottles and sachets was used for data collection.The questionnaire included socio-demographic characters, pesticide use practices, storage and disposal techniques and health effects among the farmers.The pesticides use practices was measured using certain questionnaires including amount of pesticides used, working hours, types, intervals, spraying time per season, trainings on handling, place of preparation, use of Personal Protective Equipment (PPE) and personal hygiene.Similarly, storage and disposal techniques were also measured.Farmers' health effects were measured by asking if they had any health problems within 48 hours of pesticides application due to pesticide use and symptoms.Validity of the instrument was obtained from literature review.Pretesting of the questionnaire was carried out among 10% of the total sample to ensure reliability.Ethical approval was taken National Open College for the conduction of study.The ward authorities were contacted for permission to conduct the study.Participants were briefed about the study objectives and informed written consent was taken from each respondents before collecting the data.Participation in the study was fully voluntary and confidentiality of the collected information were ensured.Each filled questionnaire was re-checked just after completion of the interview.Data entry was carried out in Epi-Data and analyzed using the IBM SPSS version 21.The data analysis was carried out using descriptive statistics where frequency, percentage, mean and standard deviation were calculated to find out the socio-demographic characteristics, pesticide use practices, storage and disposal techniques and health effects of pesticides among the farmers.

IJFMR230611438
Volume 5, Issue 6, November-December 2023 4  1 represents the descriptive statistics for socio-demographic characters of the respondents.It shows that 52% of the respondents were male and 48% of them were female with mean age 40.7 years and standard deviation of 9.28 years.The majority of respondent, that is, 66.4% is falling between 30 and 46 years, showcasing a relatively mature farming demographic.Most of the respondents were Brahmin/Chhetri (66%).Almost half of the respondent, that is, 55% have education levels beyond primary.Farming experience and pesticide exposure was also diverse, with most farmers engaged in farming for 1-5 years was 56.3% and 57% have 1-5 years of pesticide use experience.The majority of farmers do not own the land on which they farm, with 83.2% having leasehold land.  2 represents data on pesticides use practices as well as Integrated Pest Management.Majority 68.2% of the respondent relies on the dealer's guides for amount of pesticides use.Almost 43% of respondent spend 2-6 hours while working with pesticides in the field.Majority of respondent, that is, 32% waited for 3-5 days before harvesting vegetables after pesticide application.Pesticide application intervals ranged from weekly with 33% to alternate days with 7%, and most farmers sprayed pesticides more than six times per cropping season.All farmers purchased pesticides from authorized shops.Regarding pesticide preparation, 42% of farmers prepared pesticides in the field, 32% prepared at home and 21% in water sources, resulting in contamination of water.Almost three fourth of the respondents washed their sprayer equipment after use with most of them (38.7%)washed at the farm sites.About 58% of farmers reported that they re-enter in field within 0-2 days after pesticide application posing potential health risks.The study emphasized the importance of reading pesticide labels, as 56.3% of farmers did so, with 74% of them following label instructions.Most of the respondents, that is, 71% determined wind direction before spraying pesticides.Majority of the respondents (88%) reported about not eating, drinking or smoking during pesticides application.Awareness on Integrated Pest Management (IPM) was reported by less than half (45%) of the respondents with 87.5% of them using IPM techniques with more than half of them using trap methods.4 represents the data regarding the knowledge about the pesticides effect and health problems experienced by the respondents within 48 hours of pesticide application.It shows that majority of the farmers exhibited knowledge of pesticide effects on health, the environment, and animal health with 89%, 91% and 83% respectively.Similarly, more than half (58.3%) of the respondents were known about the routes of pesticide entry into the human body where they reported route of entry through skin, ingestion and inhalation.Furthermore, almost half of the respondents, that is, 45.6% reported about experiencing health problems such as eye irritation, headache, dizziness, fever, vomiting, and shortness of breath, convulsion or skin irritation within 48 hours of pesticides application.

Discussion
Our study, involving 107 commercial vegetable farmers in Nepal, produces a meticulous interpretation of the complexity around pesticide use.By combining these findings with information from international organizations, especially studies conducted in Palestine (13), Uganda (14), Kenya (15) and Vietnam ( 16), the similar problems encountered be all of us are revealed while making clear that to solve them requires a global effort that is coordinated across countries doing things together for mutual benefit.In terms of demographic characteristics, our participant pool is heavily dominated by relatively mature farmers (60.4 % between 37 to 51 years), which matches the age distribution observed elsewhere in Palestine such as Nablus district (13).This congruency in terms of age profiles between different geographical areas means that interventions must be designed to deal with the precise needs and habits of this aging farming population.The big gap between the education levels of farmers in Nepal, from illiterate to university degree holders, is a universal problem.Its correlation with findings from Uganda (14) further accentuates the very pressing international problem of low rural awareness about correct use of pesticides.It is clear that this need for more attention through education and training exists, supporting the focus on raising awareness among farmers in Nepal of our study.The similarity in effects we observed between Nablus, Palestine (13) and the literature review reinforces our study's focus on widespread occurrence of pesticiderelated health problems.This points to the urgent need for an overall approach in order jointly develop methods of dealing with challenges confronting farmers everywhere.In terms of health impact, these parallels reveal the need for concerted efforts to reduce differences in pesticide use patterns.Education and legislation are both pervasive themes, in sync with studies from Kenya (15) as well the regulatory frameworks of Nepal.The common thread among them is we need effective legislation, enforcement and education on a global scale to reduce health risks from pesticide use.This shared emphasis underscores the importance of international campaigns to promote education about existing legislation, as reflected in data from various regions.In our study and from Uganda (14), of difficulties understanding pesticide labels underline the urgent need worldwide to improve farmers 'understanding about pesticides.This is consistent with the international demand for clearer labelling and intervention projects.The need also exists to develop global strategies that will increase understanding of pesticides, reduce risks, enhance efficiency in their use and improve people's quality of life.The emphasis on Integrated Pest Management (IPM) in our study follows a trend found worldwide, according to results of another.Perhaps in Vietnam ( 16) the recognition of obstacles to pesticide use also indicates some kind of need for sustainability everywhere, and this is consistent with our strategy's opposition perspective.This shared point of view makes it clear that we must encourage environmentally friendly agricultural techniques on a world scale.The call for international cooperation in studies from California (17), Rwanda (18) and Iran ( 8) is consistent with our call to train many foreign trainees.Agricultural practices that are so interrelated and deeply shared become an even clearer demonstration of why cross-border collaboration is necessary to promote safer agricultural practices around the world.Therefore all parties have a shared responsibility in emphasizing the importance of collective efforts and knowledge exchange towards better, safer practices everywhere.Our study's emphasis on fine-tuning education and training is in line with the recognition of a gap between knowledge among farmers, but practice in Iran (8).This common awareness stresses that without practical experience, having knowledge doesn't equate with safe practices.This relates to the global call for effective bridging of gaps in agricultural techniques.Studies from Kenya (15), Iran (8) and Uganda ( 14) have combined thorough empirical knowledge with breakdowns of socio-economic factors to lend more weight to the point that local conditions must be understood.This global focus on socio-economic factors reminds us once again of the importance of integrated prevention, stressing preventive methods linked to conditions local to Nepal.In conclusion, when linked with international data on the subject and viewed in light of our own study's findings, it becomes obvious that we must take collective multidisciplinary measures if farmers around the world are to be protected from occupational health risks arising out of pesticide use.Similarly, the common difficulties faced by different regions highlight that effort to achieve responsible agriculture and food production at an international level is of great urgency.All the results of this study are consistent with a cohesive story: we must not only avoid selectively limiting attention to isolated cases, but on an international level must take comprehensive and collective action in order to prevent pesticide pollution from further harming human health.

Conclusion
Commercial vegetable farmers from two wards of Kirtipur Municipality took part in the study that accesses their occupational health hazards related to pesticide use.Demographic features of the vegetable growers showed that majority of them were literate and among them majority had secondary level school education.Most of the respondents had work experience as pesticide applier ranged from 1 year to 5 years.Four fifth of the farmers had leasehold farmland.The study showed that extremely hazardous pesticides were used in vegetables which were banned for normal agriculture use by Government of Nepal.Majority growers did not receive any training on pesticides and IPM techniques.Four fifth farmers used at least one PPE during the application of pesticide.The study showed that almost half of the farmers were known about health impacts of pesticide.Similarly, three-fourth farmers were familiar with route of exposure.Around half of the pesticide users had shown various symptoms of health hazards such as headache, vomiting, shortness of breath, skin and eye problem.Many farmers are still suffering from different health hazards.For this, there is a need of the promotion of effective cultivation practices .The hygiene and sanitation practices of the pesticide users require much improvement.To effect change, the health and agriculture sector should work together.The agriculture sector should develop and build on ways of working with framers to grow vegetables that promote healthier cultivation practices and reduce the exposure to the pesticide.The health sector should document the health problems and identify the health hazards.Furthermore, it help explain the reasons for such changes and monitor changes in health with improved production method.

Limitations
This study did not cover a large population and was limited in two wards of Kirtipur Municipality, so the findings from the study could not be generalized and hence a proper estimation of the problem was not possible.Moreover, this study was limited to both time and resources and did not cover all the aspect of the occupational health and safety among the commercial vegetable farmers.However, it focused on some of its important aspects.Before moving into thick of things, we would like to add a few words of appreciation for the people who have been in the part of this study right from the beginning.We owe our credit to all the helping hands whose invaluable help, support, patience and guidance has made the completion of this research possible.Foremost, it is a privilege to conduct the study on "Occupational health hazards of pesticides use among commercial vegetable farmers of Kirtipur Municipality, Kathmandu".Our earnest gratitude is expressed towards our research supervisor, Dr. Ashok Kumar Paudel with whom it was our immense pleasure and honour to work.Without his kind supervision, guidance, and continuous help, our research would not have taken this shape.Similarly, we would like to thank to all those respondents who gave their valuable time and information without whom this study would not have been completed.With the sincere attempt, we have tried to do our best and hope that this research will be of help and reference for future attempts.Lastly, our acknowledgement extend to all those who helped us directly and indirectly for accomplishment of this study.

Table 3
represents the data regarding the use of Personal Protective Equipment during pesticides handling and application.It shows Personal Protective Equipment usage was encouraging with 89% using at least one or more PPE such as masks, gloves, boots, glasses, hat or head cover, full sleeves shirt, full length trousers or raincoat while handling pesticides.Among few respondents who were not using any PPE, almost half of them reported that PPE was not necessary or was uncomfortable to them.Different practices had been recorded after pesticides use, with 87% respondent changed clothes, 89% took bath after each episode of pesticides application, and 79% separately washed clothes used during pesticides application.Similarly, the storage practices were concerning, as 33% stored pesticides inside homes, leading to potential contamination.Furthermore, almost half of the respondents, that is, 45.1% burned empty pesticide bottles, as pesticides disposal practices.