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Pesticide handling practices, health risks, and

determinants of safety behavior among Iranian
apple farmers

Asghar Bagheri, Naier Emami, Mohammad Sadegh Allahyari & Christos A.

Damalas

To cite this article: Asghar Bagheri, Naier Emami, Mohammad Sadegh Allahyari & Christos A.
Damalas (2018) Pesticide handling practices, health risks, and determinants of safety behavior
among Iranian apple farmers, Human and Ecological Risk Assessment: An International
Journal, 24:8, 2209-2223, DOI: 10.1080/10807039.2018.1443265

To link to this article: https://doi.org/10.1080/10807039.2018.1443265

Published online: 14 Mar 2018.

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HUMAN AND ECOLOGICAL RISK ASSESSMENT
2018, VOL. 24, NO. 8, 2209–2223
https://doi.org/10.1080/10807039.2018.1443265

Pesticide handling practices, health risks, and determinants

of safety behavior among Iranian apple farmers
Asghar Bagheria, Naier Emamia, Mohammad Sadegh Allahyarib,
and Christos A. Damalasc
a
Department of Water Engineering and Agricultural Management, Faculty of Agricultural Sciences, University of
Mohaghegh Ardabili, Ardabil, Iran; bDepartment of Agricultural Management, Rasht Branch, Islamic Azad
University, Rasht, Iran; cDepartment of Agricultural Development, Democritus University of Thrace, Orestiada,
Greece

ABSTRACT ARTICLE HISTORY

Common safety practices in pesticide use were assessed among apple Received 3 January 2018
farmers in Ardabil Province, Iran. With reference to the place of storing Revised manuscript
pesticides, most farmers (60%) stated that they store the pesticides in accepted 17 February 2018
stalls and warehouses, while 8.5% stated that they store the pesticides KEYWORDS
in their houses. The majority of the farmers (71.5%) stated that they human health; pesticide
prepare the pesticide sprays in the orchards or next to irrigation wells. exposure; risk assessment;
Almost one out of three farmers (32.8 %) reported that they dump the toxicity
empty containers in the orchard fields and almost an equal proportion
(30.2%) reported that they usually bury the empty containers. Irritating
(burning) eyes and blurred vision were symptoms that the majority of
respondents had experienced. Most farmers used trousers, long-
sleeved blouses/shirts, and gloves when spraying, but coveralls and
goggles were rarely used. Age and farming experience negatively
affected PPE use and safety behavior, namely old and experienced
farmers did not follow safety rules. On the contrary, education,
information about pesticides, and farming as the main profession
promoted safety behavior. Overall, significant levels of exposure
among farmers can be concluded due to pesticide use. The extension
services should aim human safety in relation to pesticide use in
agriculture.

Introduction
After green revolution, application of pesticides has become an inevitable part of modern
agriculture. These chemicals are abundantly used in most agricultural sectors to combat nox-
ious pests, diseases, and weeds, to prevent yield losses, and to maintain crop productivity,
contributing to economic growth (Fadipe et al. 2014). Pesticides are designed to be toxic to
harmful pests and are deliberately released in the environment for this purpose. Without

CONTACT Asghar Bagheri bagheri_a2001@yahoo.com Department of Water Engineering and Agricultural Manage-
ment, Faculty of Agricultural Sciences, University of Mohaghegh Ardabili, Ardabil, Iran; Christos A. Damalas chris.
damalas@yahoo.gr; cdamalas@agro.duth.gr Department of Agricultural Development, Democritus University of Thrace,
Orestiada, Greece.
Color versions of one or more of the figures in the article can be found online at www.tandfonline.com/bher.
© 2018 Taylor & Francis Group, LLC
2210 A. BAGHERI ET AL.

pesticides, the productivity of modern agriculture would be impossible and also public health
could in some cases be compromised (Damalas 2009). However, mishandling of these chem-
icals may have severe health effects on farmers, farm workers, and the environment (McCau-
ley et al. 2006; Damalas and Eleftherohorinos 2011), negative indirect effects on soil and
water quality (Zhang et al. 2015), and social costs (Huang et al. 2000).
The problem of uncontrolled and irresponsible pesticide use in agriculture has
become a worldwide concern (Ashraf et al. 2012). Pesticide toxicity, commonly illus-
trated as headache, nausea, vomiting, rashes, respiratory failure, disorientation, and
even death, is known as the most important occupational hazard for farmers (Coro-
nado et al. 2004; Damalas and Koutroubas 2016). Acute poisoning by pesticides is often
reported as a major public health problem throughout the world, after the intensifica-
tion of agriculture and the extensive promotion of agrochemicals in developing coun-
tries, resulting in 300,000 deaths annually (Konradsen 2007). In farming, individuals
who deal with pesticides are prone to these chemical substances due to pesticide spills,
direct spray contact due to missing protective equipment, or even pesticide drift (Dam-
alas and Koutroubas 2016). However, other activities not directly related to pesticide
use also can be a serious source of pesticide exposure for farmers.
Personal protective equipment (PPE) can prevent pesticide exposure of farmers dur-
ing pesticide handling and its use is necessary in the use of agrochemicals. For example,
several studies concluded that PPE can prevent farmers’ exposure to pesticides (Tsakir-
akis et al. 2010), irrespective of pesticides investigated, PPE items tested, and types of
exposure measured. Recently, protective gloves and hygiene practices appeared to be
important modifiers of the association between pesticides and Parkinson’s disease (Fur-
long et al. 2015). Although PPE use minimizes farmers’ exposure to pesticides, many
studies have confirmed that PPE is often not used (Damalas and Hashemi 2010; Feola
and Binder 2010; Hashemi et al. 2012) or is used wrongly (Blanco-Mu~ noz and Lacasa~ na
2011; Yuantari et al. 2015).
The county of Meshgin Shahr is an important area of horticultural production, especially
apples (Statistical Center of Iran 2014). Farmers of this county use large amounts of pesti-
cides in their apple orchards each year (Heidari et al. 2016). Due to the use of several insecti-
cides and fungicides in apple orchards, there are numerous problems that are directly related
to exposure to pesticides, particularly for farmers and farm workers who are involved in pes-
ticide spraying. In addition, environmental pollution, human health hazards, and product
contamination by pesticides are among the consequences of pesticide use (Kabbaz Jolfaie
and Azimi 2014). Evidence shows that occupational safety and health in the Iranian agricul-
tural sector is a neglected issue, as few farmers receive training in occupational health (Kar-
ami et al. 2016). In this regard, the objective of the present research was to study the use of
pesticides, pesticide health risks, and determinants of safety behavior by the apple farmers of
this county for providing proper policy strategies of optimum management of pesticide use.

Methodology
Study area
The study was conducted in Meshgin Shahr County of Ardabil Province in Northern Iran
(Figure 1). Meshgin Shahr County with five districts and 704 villages, having a population of
 HUMAN AND ECOLOGICAL RISK ASSESSMENT 2211

Figure 1. Map of the research area (Meshgin Shahr County).

about 164,000 people, is the second largest county of Ardabil Province. With an area
of 3615 km2, it is located in Northwestern Iran, neighboring Azerbaijan (Figure 1). Because
of favorable climatic conditions and fertile soils, the county is one of the major agricultural
areas of the province, with a variety of summer and winter crops and fruits grown. For
example the quality of its grape and apple is well known throughout the country. The total
farmland extent of the county is 161,446 ha, of which 14,691 ha are related to orchards. The
apple orchards cover 6710 ha of the farmland and produce 91,000 tonnes of apples annually.
Crop and horticultural sectors have a special place in the area, in which 28,480 villagers and
4516 urban people are engaged in crop and orchard farming in the county. However, despite
extensive pesticide use for crop protection in apple trees in the area, studies pertaining to
pesticide use among apple farmers in this area do not exist. Therefore, apple farmers were
selected as the target group of this study.

Population and sample

The study was carried out among apple farmers of Meshgin Shahr County. Meshgin Shahr
County is divided into five distinct districts: Central, East, Qasabeh, Arshagh, and Moradlou.
The sum of apple farmers in the five districts (strata) at the time of the study was 1492. A
stratified sampling method was employed and proportional sample allocation was utilized
for selecting farmers according to the size of each stratum (district). The least sample size
for the study was estimated to be 183 farmers, based on the least sample size table proposed
by Bartlett et al. (2001), considering a confidence level of 99%. Also, the margin of error
used in this table was 3% for continuous data. Due to low return rate in studies of this kind,
an additional 10% of the target population was included to the initial sample size to ensure
2212 A. BAGHERI ET AL.

participation of the required sample size. Therefore, 200 questionnaires were distributed
among apple farmers.

Data collection and analysis

A self-made questionnaire consisting of farmers’ socioeconomic profile (i.e., age, orchard
farming experience, family size, residence location, marital status, education level, farming
employment, and participation in extension activities), pesticide toxicity problems, safety
behavior, PPE use, and pesticide handling practices was used as the main instrument of the
study for data collection. Common pesticides used in the area are presented in Table 1. With
reference to pesticide toxicity problems, it was stressed that we were referring to health
impairments related to pesticide handling. Therefore, farmers were asked to report only
health complications caused by pesticide handling. Most of the statements were in the form
of five-point Likert-type scales ranging from never (D 1) to always (D 5). Disposal methods
of pesticide containers, pesticide storage, and preparation place of pesticide solutions were
studied using open-ended questions; the frequencies and percentages of each response were
calculated. A panel of experts confirmed the face validity of the instrument. Before conduct-
ing the field stage of the research and to check the reliability of the survey instrument, a pilot
study was conducted among a sample of 30 apple farmers from a village of the region out of
the sampled villages. Then, the instrument was modified to fit the specific local conditions
and the Cronbach’s alpha was calculated for each scale. The Cronbach’s alpha values of 0.74,
0.87, and 0.83 for poisoning symptoms, PPE use, and safety behavior, respectively, implied
an acceptable reliability of the scales. The final draft of the instrument was used for data col-
lection. The face-to-face method of interviewing was used for data collection, taking into
Table 1. Active ingredients of common pesticides used in the study area.
Common name WHO class Type/use

Copper oxychloride II Fungicide

Bordeaux mixture II Fungicide
Captan U Fungicide
Dodine II Fungicide
Thiophanate-methyl U Fungicide
Mancozeb U Fungicide
Boscalid U Fungicide
Sulfur III Fungicide
Tebuconazole II Fungicide
Tetraconazole II Fungicide
Diazinon II Insecticide
Chlorpyrifos methyl III Insecticide
Fenvalerate II Insecticide
Imidacloprid II Insecticide
Acetamiprid II Insecticide
Ethion II Insecticide
Thiacloprid II Insecticide
Fenpyroximate II Acaricide
Hexythiazox U Acaricide
Propargite III Acaricide
Bromopropylate U Acaricide
Pyridaben II Acaricide
Clofentezine II Acaricide
Fenpropathrin III Acaricide
Glyphosate III Herbicide
Paraquat II Herbicide
 HUMAN AND ECOLOGICAL RISK ASSESSMENT 2213

account the low education levels of most farmers and the specific nature of some questions.
This method increased comprehensibility of the questionnaire and the accuracy of the col-
lected information.
Statements and scales of PPE use, poisoning symptoms, and safety behavior were deter-
mined according to previous studies (Ibitayo 2006; Recena et al. 2006; Ghasemi and Karami
2009; Feola and Binder 2010; Gaber and Abdel-Latif 2012; Al Zadjali et al. 2015; Weng and
Black 2015; Damalas and Abdollahzadeh 2016; Houbraken et al. 2016; Garcıa-Garcıa et al.
2016). To study the extent of PPE use, eight protective items were listed and respondents
were asked to indicate how much they used each of the items during spraying in a five-point
Likert-type scale from never to always (never D 1, rarely D 2, sometimes D 3, often D 4, and
always D 5). Free space for mentioning additional PPE items out of the given list was also
included. To study respondents’ poisoning experience during pesticide handling, nine poi-
soning symptoms were listed and farmers were asked whether and how much they suffered
from the listed symptoms during pesticide handling in a five-point Likert-type scale from
never (D 1) to always (D 5). Free space for mentioning symptoms out of the given list was
also included. With reference to safety behavior, this variable was studied with 11 statements
in the same manner. After data collection in the field, the data were analyzed with the Statis-
tical Package for Social Sciences (SPSS) software (ver. 23).
For each statement, frequencies, percentages, mean scores, and standard deviations were cal-
culated. Then, the scores of each scale were summed up for further analysis. Spearman rank-
order correlation, a statistical test of the strength of a monotonic relationship between two varia-
bles, was used for assessing the statistical relation between two variables. Like conventional corre-
lation coefficient, Spearman rank-order correlation has a value between –1 and C1. A value of 0
indicates no relationship and values of C1 or –1 indicate a perfect positive or negative correlation
between the two variables, respectively. The difference is that Spearman rank-order correlation
refers to the ranked values rather than the original measurements. This test is appropriate for
both continuous and discrete variables, including ordinal variables (Norman and Streiner 2008).
It is applied when the data are non-normally distributed or when the data are not continuous.
Unless otherwise stated, relationships were considered significant at p < .05. Also, linear regres-
sion analyses were employed to reveal factors affecting safety behavior and PPE use.

Results
Farmers’ sociodemographic profile
The average age of the farmers was 52.9 years. Just less than half of the farmers (44.0%) were
older than 50 years of age, 42.5% were in the age group 30–50 years, and 13.5% were younger
than 30 years, implying that farmers were relatively old (Table 2). The average farming expe-
rience of farmers was 25.5 years and the majority of the farmers were married (89.0%). The
family size was 1–3 individuals for 39.5% of the farmers and 4–6 for 41.0% of the farmers.
Three out of four farmers (75.0%) were residents of rural areas and most were full time farm-
ers (84.0%). Concerning education background, more than half of the farmers (54.0%) had
education of secondary high-school, 27.0% had a diploma (12 years education certificate),
and the rest were graduates of higher education centers. Almost a quarter of the respondents
(27.0%) had participated in extension courses on application of pesticides, with main
emphasis on time and amount of pesticide use, and not on personal protection in pesticide
2214 A. BAGHERI ET AL.

Table 2. Socioeconomic profile of the farmers (n D 200).

Variable Frequency Percentage Mean SD

Age (years) 52.9 10.14

Less than 30 27 13.5
From 30 to 50 85 42.5
More than 50 88 44.0
Farming experience (years)
Less than 10 40 20.0 25.5 12.98
From 10 to 30 88 44.0
More than 30 72 36.0
Marital status
Married 178 89.0
Single 22 11.0
Family size (person) 4.46 2.43
From 1 to 3 79 39.5
From 4 to 6 82 41.0
More than 6 39 19.5
Residence location
Village 150 75.0
Urban 50 25.0
Farming employment
Full time 168 84.0
Part time 32 16.0
Education level
Secondary high-school 108 54.0
Diploma 54 27.0
Higher education 38 19.0
Participation in extension
Yes 54 27.0
No 146 73.0

use (Table 2). Weather conditions when spraying and hygiene practices (e.g. smoking, eat-
ing, and drinking when spraying) were included in these courses.

Pesticide storage, spray preparation, and disposal of pesticide containers

With reference to the place of storing pesticides, 31.5% of the farmers reported that they usu-
ally apply the pesticides immediately after buying. However, most farmers (60%) stated that

Table 3. Disposal of empty containers, storage, and preparation of pesticides (n D 200).

Method Percentage

Disposal method
Dumping in orchards 32.8
Burying 30.2
Throwing in canals 10.0
Burning 17.0
Washing and using for animal watering 10.0
Storage place
Stalls and warehouse 60.0
Applied it after buying 31.5
Houses 8.5
Preparation place
Orchard 51.5
Next to well 20.0
Stall 17.0
Kitchen 8.0
No response 3.5
 HUMAN AND ECOLOGICAL RISK ASSESSMENT 2215

they store the pesticides in stalls and warehouses, while 8.5% stated that they store the pesti-
cides in their houses (Table 3). Because orchards of most respondents were close to their
homes, 8.0% and 17.0% prepared the pesticide sprays in their kitchen and stalls, respectively.
However, the majority of the farmers (71.5%) stated they prepare the pesticide sprays in the
orchards or next to irrigation wells. With reference to the question about disposal of empty
pesticide containers, several practices were recorded. Almost one out of three farmers (32.8
%) reported dumping the empty containers in the orchard fields. Almost an equal propor-
tion of the farmers (30.2%) reported that they usually bury the empty containers. Some
farmers reported that they burn the empty containers (17%), throw them in irrigation canals,
regardless of their fate (10%), or wash them for using in watering of domestic animals (10%)
(Table 3).

Poisoning symptoms by pesticide handling

Several symptoms of pesticide poisoning were reported, but only 17% of the farmers noted
that they were hospitalized due to pesticide poisoning (Table 4). Burning eyes and blurred
vision were symptoms that the majority of respondents had experienced (Table 4). On the
other hand, abdominal pain, dizziness and headache, and chest pain were not so common
among respondents, with more than 60%, 50%, and 70% of the respondents reporting that
they did not seriously suffer from such symptoms of pesticide poisoning (Table 4).

Personal protective equipment (PPE) use

Farmers noted that they did not use PPE when storing pesticides or preparing pesticide
sprays. They only used PPE during spraying times. The majority of the farmers used trou-
sers, long-sleeved blouses/shirts, and gloves (Table 5). Hat/kerchief, boots, and mask were
moderately used, whereas coverall and goggles were rarely used by farmers. With reference
to gloves, farmers of the study area used rubber gloves 30–35 cm long and/or two-layer hor-
ticultural gloves with internal linen layer and external layer of rubber during spraying. Both
types of gloves prevent the contact of toxic solution by hands. They also used under knee
high boots. Other PPE items, except goggles, i.e., trousers, blouse, shirt, hat, handkerchief,
and mask were of cotton or other kinds of fabric.

Table 4. Poisoning symptoms when working with pesticides.

Poisoning symptom N R S O A Mean SD

Burning eyes 2.5 21.4 11.9 44.3 19.9 3.58 1.10

Blurred vision 6.0 17.4 21.9 33.3 21.4 3.46 1.17
Nausea and vomiting 15.9 47.8 13.4 8.0 14.5 2.57 1.26
Anxiety 18.9 36.3 26.4 10.4 7.5 2.51 1.13
Diarrhea 31.3 32.8 9.5 16.4 9.5 2.46 1.43
Skin burning and irritation 16.9 42.8 25.9 10.0 4.0 2.41 1.01
Abdominal pain 24.4 36.8 23.4 6.0 9.0 2.38 1.18
Dizziness and headache 9.9 40.8 29.4 4.5 5.0 2.33 1.00
Chest pain 38.3 42.3 8.5 2.5 8.0 1.99 1.13

N: never; R: rarely; S: sometimes; O: often; A: always.

Cronbach’s alpha D 0.74, scale: from never (D 1) to always (D 5).
2216 A. BAGHERI ET AL.

Table 5. Frequency of PPE use by farmers during spraying (n D 200).

PPE item N R S O A Mean SD

Trousers — — — — 100 5.00 0.00

Gloves — — 20 80 4.80 0.40
Long-sleeved blouse/shirt — — — 24 76 4.73 0.44
Boots 5 10 41 19 25 3.71 1.07
Hat/kerchief — 10 30 15 45 3.19 1.01
Mask 25 15 10 7 43 2.88 1.67
Coverall 5 42 53 — — 2.46 0.61
Goggles 30 26 21.5 15 7.5 2.24 1.14

N: never; R: rarely; S: sometimes; O: often; A: always.

Cronbach’s alpha D 0.87, scale: never (D 1) to always (D 5).

Hygiene practices in pesticide application

Some safety behaviors that are needed to be considered by farmers were examined (Table 6).
Washing hands with warm water and soap after spraying, not eating or drinking during
spraying, not smoking during spraying, changing clothes and taking a shower after spraying
were considered by almost all farmers. Maintaining pesticides in safe places and using eco-
friendly and low toxic pesticides were the less considered safety behaviors.

Factors influencing PPE use and safety behavior

To investigate factors influencing farmers’ behavior, the scores of 11 statements of safety
behavior and those of eight PPE items used were summed up. The higher the scores, the
more safety behavior and the more use of PPE. The extent of PPE use and safety behavior
was significantly associated with education, information, age, and farming experience. More
educated farmers used more PPE and behaved more safely. Spearman rank-order correlation
of high value implies the importance of education (Table 7). Moreover, information usage
was another variable that highly correlated with those variables. Farmers with more informa-
tion showed more safety behavior and used more PPE during spraying. Age of farmers was
negatively correlated with PPE use (Table 7). In other words, younger farmers used more
PPE. Also, farming experience was negatively correlated with safety behavior, implying that
more experienced farmers considered less safety practices in pesticide use. Moreover, signifi-
cant association was also found between PPE use or safety behavior and poisoning

Table 6. Respondents’ safety behavior in pesticide application.

To what extent do you do the following actions? Mean SD

Washing hands with soap after spraying 4.84 0.31

Not eating/drinking during spraying 4.75 0.43
Not smoking during spraying 4.75 0.43
Changing dress and taking a shower after spraying 4.71 0.55
Prevent entering children to orchard after spraying 4.52 0.73
Applying prescribed dose of pesticides 4.51 0.59
Prevent entering animals to orchard after spraying 4.24 0.81
Reading instructions of pesticide before spraying? 4.22 0.67
Washing clothes of spraying separately 3.93 0.96
Maintaining pesticides in safe places 3.62 1.37
Using eco-friendly and low toxic pesticides 3.33 1.06

Cronbach’s alpha D 0.83, scale: never (D 1) to always (D 5).

 HUMAN AND ECOLOGICAL RISK ASSESSMENT 2217

Table 7. Correlation analysis of PPE use and safety behavior with demographic variables.
PPE use Safety behavior

Variable Coefficient p-value Coefficient p-value

Age ¡0.201 .004 ¡0.117 .099

Farming experience 0.016 .837 ¡0.431 .000
Education 0.614 .000 0.437 .000
Information usage rate 0.398 .000 0.164 .021
Poisoning symptom ¡0.233 .001 ¡0.267 .000

symptoms (Table 7). Accordingly, farmers who considered less safety practices and used less
PPE, suffered more poisoning due to pesticide spraying.
The factors influencing PPE use and safety behavior were identified via regression analysis
(Table 8). The F values of both models were significant. Tolerance and variance inflation fac-
tor (VIF) results indicated no collinearity problems and thus all correlated prediction varia-
bles could be entered to the regression analysis. According to the results, education and
employment with positive effect and age with negative effect were key factors explaining
PPE use that accounted for 44.1% of the variance (R2 D 0.441). According to the significant
predictors of PPE use (Y1) of Table 8, the regression model is as follows:

Y1 D 20:355 C 4:058 .education/ C 1:677 .employment/ ¡ 0:181 ðageÞ

Also, education and information usage with positive effect and farming experience
with negative effect were key factors explaining safety behavior that accounted for
40.5% of the variance of safety behavior of respondents (R2 D 0.405). According to the
significant predictors of safety behavior (Y2) of Table 8, the regression model can be
presented as follows:

Y2 D 29:841 C 1:642 ðeducationÞ C 1:088 ðinformationÞ ¡ 0:103 .farming experience/

Table 8. Regression analyses to explain factors influencing PPE use and safety behavior.
Model Y1 (PPE use) B Std. error Beta t p-value Tolerance VIF

Constant 20.355 0.856 — ¡23.783 .000 — —

Education 4.058 0.455 0.549 8.911 .000 0.925 1.018
Employment 1.677 0.395 0.262 4.245 .000 0.983 1.017
Age ¡0.181 0.063 ¡0.201 ¡2.888 .004 0.967 1.034
F D 61.839, p D .000

Model Y2 (Safety behavior) B Std. error Beta t p-value Tolerance VIF

Constant 29.841 0.443 — 67.422 .000 — —

Education 1.642 0.24 0.437 6.836 .000 0.841 1.189
Farming experience ¡0.103 0.013 ¡0.448 ¡8.115 .000 0.967 1.034
Information usage rate 1.088 0.409 0.147 2.660 .008 0.935 1.069
F D 46.728, p D .000

Model Y1 (PPE use): R2 D 0.441; R2 Adj. D 0.434.

Model Y2 (Safety behavior): R2 D 0.405; R2 Adj. D 0.396.
2218 A. BAGHERI ET AL.

Table 9. Percentages of respondents using each of the information sources.

Information source Use (%)

N R S O A M SD

Plant protection clinics (private) 24.9 49.3 25.8 — — 2.00 0.71

Agricultural and extension experts 49.8 — 10.4 19.9 19.9 2.60 1.69
Unlicensed pesticide retailers 37.3 12.9 19.9 19.9 10.0 2.41 0.74
Other informant farmers 5.0 10.0 58.6 26.4 — 4.22 1.04
Instruction of containers 5.0 — 14.9 27.9 52.2 2.81 0.65

N: never; R: rarely; S: sometimes; O: often; A: always.

M: mean on a scale: never (D 1) to always (D 5); SD: standard deviation.

With reference to information usage, farmers reported using various resources for infor-
mation about pesticide use (Table 9). Other farmers were the source with the highest prefer-
ence, followed by instructions of containers and extension experts.

Discussion
Today, there is a growing body of evidence in the literature that the poor knowledge and
awareness of farmers about pesticide hazards as well as the overuse of these products has
become a serious problem in developing countries, which threatens farmers’ health in many
ways (Zyoud et al. 2010; Gaber and Abdel-Latif 2012; Weng and Black 2015; Yantari et al.
2015; Elibariki and Maguta 2017; Damalas and Khan 2017). Therefore, understanding farm-
ers’ behavior in pesticide handling is an important issue. The present study was carried out
to investigate the health issues and safety behavior of apple farmers during handling pesti-
cides in Meshgin Shahr region of Ardabil Province. Similar studies with respect to pesticide
handling practices and safety behavior among Iranian apple farmers do not exist in Iran and
the findings of this study may be useful for policy-making on pesticide management in the
area. The safety behaviors included PPE use during pesticide handling, application of less
toxic pesticides, and hygiene practices after pesticide application. Disposal methods of empty
pesticide containers, storage place of pesticides, and preparation of pesticide sprays are also
key health issues in practice. These issues are essential for extension education programs.
Sixty percent of the respondents stored the purchased pesticides in improper places, i.e.,
warehouses and stalls, with the least care. Furthermore, more than 40% of the respondents
also dumped the empty pesticide containers into orchards or threw it in canals. Similarly,
Mohanty et al. (2013) found that around 68% of the farmers in South India indiscriminately
disposed empty containers, while 48% buried the leftover pesticides. Also, Zyoud et al.
(2010) also found that most farmers in Palestine disposed of empty pesticide containers with
the least care. On the contrary, Gaber and Abdel-Latif (2012) found that more than half of
the farmers in Egypt disposed off the empty containers with usual trash. Dumping contain-
ers in the orchards or throwing them in irrigation canals and streams can result in pesticide
residues entering the environment (Damalas and Eleftherohorinos 2011) and is a totally
unsafe practice that has been reported as a major problem in a number of studies (Ntow
et al. 2006; Recena et al. 2006; Damalas et al. 2008). Therefore, improper disposal of empty
pesticide containers can harm humans, animals, and the environment (Mohanty et al.
2013). Disposal of empty containers should always be in accordance with FAO guidelines
and international regulations, considering three standard rinsing options, i.e., triple rinsing,
 HUMAN AND ECOLOGICAL RISK ASSESSMENT 2219

pressure rinsing, or integrated pressure rinsing (FAO 2008). It should be noted, however,
that most farmers in the study area do not get any advice or incentives for proper disposal of
pesticide empty containers, because of lack of regulations and any institute or governmental
organization for the control of disposal of pesticide containers. Also, few studies have been
conducted in Iran with respect to pesticide waste management to help policy-makers in the
country’s agricultural sector. Therefore, the findings of this study may be useful for policy-
making on pesticide waste management in Iran. Poor understanding of farmers on pesticide
storage, application, and disposal has been recently reported in other developing countries
(Elibariki and Maguta 2017; Damalas and Khan 2017). However, farm workers from Califor-
nia understood many of the potential health consequences of exposure, while holding ele-
vated levels of risk perception relative to the general public (Cabrera and Leckie 2009). Even
in this case, however, the respondents continued to participate in unnecessarily risky behav-
iors. Considering this perspective, farmers need to be trained on how to properly dispose of
pesticide containers. In a recent study, previous training of farmers was associated with
increased levels of knowledge of pesticides and beliefs about pesticide hazard control, was
accompanied by elevated safety behavior in farmers, and therefore was connected with lower
occupational exposure to pesticides (Damalas and Koutroubas 2017). Indeed, farmers who
participated in education programs suffered significantly less poisoning symptoms in the
study area; however, there was no training program for proper storing and disposing of
empty pesticide containers in the farmers of the study area. This may be because the exten-
sion experts did not consider storing pesticides and disposing of empty pesticide containers
as important issues in education programs. Providing incentives and special extension serv-
ices could be appropriate ways to motivate farmers about how to store pesticides and dispose
of empty containers. For instance, special credit should be allocated at purchasing pesticides,
when the containers are returned to the retailer, packaging companies, or manufacturers.
Burning eyes (64.2%) and blurred vision (54.7%) were the most common symptoms of
pesticide poisoning reported by the farmers. However, 83% of the respondents did not go to
hospital nor were visited by physicians for the mentioned poisonings. Actually, empirical
evidence of the authors suggests that farmers did not consider these symptoms as poisoning,
but rather as natural behavior after pesticide spraying. This finding shows that farmers do
not have enough knowledge and information about the effects of unsafe spraying, as they
were unaware of the pesticide risks on human health and also they often ignored typical
symptoms of pesticide poisoning. Extension education programs in the study area mostly
focused on the best methods of spraying for pest control, whereas health issues were often
neglected. Extension education should aim more at heath issues in pesticide education. In
this study, there was no item about farmers’ dietary or food intake. Furthermore, some
reported health complications could be due to the heavy workload of farmers during pesti-
cide use, given that pesticide spraying is a time-consuming and tiring task. However, we
emphasized that we were referring to health complications caused by pesticide handling and
not to any health problem. Moreover, the study area is mountainous with rather cool
weather and therefore working under sunlight does not have the same negative consequen-
ces that may be seen in hot climates.
All respondents used trousers and long-sleeved blouses/shirts, whereas coverall and gog-
gles were rarely used. This information is important, considering that previous studies
reported reduced farmers’ exposure to pesticides with PPE use (Tsakirakis et al. 2010) and
increased pesticide exposure with less use of PPE (Damalas and Abdollahzadeh 2016).
2220 A. BAGHERI ET AL.

Contrary to reasons for low use of PPE presented by Feola and Binder (2010), the use of
long-sleeved blouses/shirts can be partially related to the cold climate of the region and the
social norm that accepts long-sleeved clothing and not necessarily related to pesticide spray-
ing. In any case, this practice represents a safety behavior. Among other PPE items, the use
of gloves was acceptable, but the use of other PPE was disappointing, confirming the findings
of previous studies (Damalas and Abdollahzadeh 2016). More than half of the farmers did
not use boots, 50% did not use hat, 77.5% did not use goggles, whereas farmers rarely used
coveralls or special clothing for spraying. The problem of poor use of PPE is not limited to
the study area. As previous studies (Feola and Binder 2010; Al Zadjali et al. 2015) found, it is
a large problem in many rural communities and the authorities have not given enough atten-
tion to it and its relationship with human health.
Despite the fact that PPE use is a major safety behavior of farmers for preventing pesticide
exposure in spraying, there are also other behaviors that can safeguard farmers during the
overall process of pesticide handling. The majority of the farmers mostly considered chang-
ing clothes, taking a shower, and washing hands with soap after spraying, as well as avoiding
eating, drinking, and smoking during spraying. However, they did not consider adequately
hygiene practices such as washing separately the clothes exposed to pesticides and storing
pesticides in safe places. In addition, because of easy availability of the currently used pesti-
cides, farmers reported minor use of eco-friendly and low toxic pesticides. In line with previ-
ous studies (Feola and Binder 2010; Damalas and Abdollahzadeh 2016), age and farming
experience negatively affected PPE use and safety behavior, whereas education had a signifi-
cantly positive effect (Al Zadjali et al. 2015). Most farmers of this study were aged and less
educated. Elderly and experienced farmers certainly have higher awareness of farming prac-
tices and pesticide risk, but they feel that after many years of farming new efforts to protect
their health are unnecessary (Damalas et al. 2006). In line with the findings of our study, pre-
vious studies showed that education and training were the main determinants of environ-
mentally sound behavior in pest control, in the sense that high levels of education and
training appeared to discourage pesticide use (Khan and Damalas 2015). Information about
pesticides also positively affected PPE use and safety behavior. Overall, significant levels of
exposure among farmers can be concluded due to pesticide misuse in the study area. The sit-
uation of careless pesticide handling is comparable with most developing countries, where
the overuse of these products has become a serious problem (Zyoud et al. 2010; Gaber and
Abdel-Latif 2012; Weng and Black 2015; Yantari et al. 2015; Elibariki and Maguta 2017;
Damalas and Khan 2017). These results may have major implications for the agricultural
authorities and extension agents to reorient their priorities and aim human safety in relation
to pesticide use in agriculture. Interventions that facilitate knowledge and compliance with
safety behaviors should become a priority for decreasing exposure to pesticides among farm-
ers (Damalas and Koutroubas 2017).

Conclusions
Information about pesticide handling practices and determinants of safety behavior were
collected among the farming community of apple farmers of Ardabil Province, Iran. The
surveyed farmers revealed much misuse of pesticides, in terms of storage practices, prepara-
tion of pesticide sprays, and disposal of empty containers along with poor levels of PPE use
in pesticide handling. Therefore, significant levels of pesticide exposure among farmers can
 HUMAN AND ECOLOGICAL RISK ASSESSMENT 2221

be concluded, considering also the reported health symptoms by pesticide use, which may
have caused severe health problems. Awareness creation and behavioral change communica-
tion are required to change farmers’ attitudes in addition to the need for training in inte-
grated pest management practices and minimizing pesticide application. Training farmers in
the safe use of pesticides is required, but training alone cannot ensure farmers’ protection
from health risks, because malpractices that expose farmers to pesticide risks cannot be
attributed to lack of information alone, but also to other factors, e.g., cost and accessibility of
proper protective items. Therefore, extension services need to be greatly improved to create
high awareness among farmers and thus promote proper practices for the safe use of pesti-
cides in all stages of pesticide use.

Acknowledgments
Financial support by the University of Mohaghegh Ardabili is acknowledged.

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