Department of Occupational Health and Safety, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.
PLoS One. 2024 Feb 15;19(2):e0298450. doi: 10.1371/journal.pone.0298450. eCollection 2024.
Pesticide poisoning is the main cause of adverse effects and mortality worldwide. Protective measures can reduce the intensity of the effects of pesticides on the health of farmers. Numerous cross-sectional studies have been conducted on the determinants of performing protective measures to reduce exposure to pesticides, but there is no systematic study that comprehensively examines the impact of these factors. Therefore, the aim of this study is to identify existing studies on the determinants of effective protective measures to reduce exposure to pesticides among farmers.
In this systematic review, studies were obtained from PubMed, Web of Science and Scopus databases using a search strategy that covered articles from the first years of database design to April 20, 2023. The inclusion and exclusion criteria were based on the PICOs criteria. The study included cross-sectional studies that measured the implementation of protective measures using objective or valid subjective tools. The data were extracted and analyzed based on several criteria and ecological levels. The Ecological Model of Health Behavior was used to classify the determinants that affect the performance of protective behaviors. The National Heart, Lung and Blood Institute (NHLBI) has developed a quality assessment tool for studies.
A total of 39 studies were ultimately selected for inclusion in this analysis. Many of these studies were conducted in developing countries. The most important factors that have an impact on protective measures include a variety of socio-demographic characteristics (age, gender, level of education, income, farming experience, experience of using pesticides), individual level (knowledge, attitude, risk perception, intention), interpersonal level (subjective norms), organizational level (education), and public policy level (government attention, health costs, governmental extension services). The quality of most studies was fair.
Research indicates that several factors influence the use of personal protective equipment and safe behaviors when handling pesticides. These include farmers' education level, knowledge, and attitudes towards safety measures. Environmental factors such as access to information, extension services, training programs, and media coverage can also help minimize exposure to pesticides.
农药中毒是全球不良影响和死亡率的主要原因。防护措施可以降低农民接触农药对健康的影响强度。已经有许多针对减少接触农药的防护措施的决定因素的横断面研究，但没有系统的研究全面检查这些因素的影响。因此，本研究的目的是确定现有的研究，以确定农民减少接触农药的有效防护措施的决定因素。
在本系统评价中，使用从数据库建立之初到 2023 年 4 月 20 日的搜索策略，从 PubMed、Web of Science 和 Scopus 数据库中获取研究。纳入和排除标准基于 PICO 标准。该研究包括使用客观或有效主观工具测量防护措施实施情况的横断面研究。根据几个标准和生态水平提取和分析数据。健康行为的生态模型用于分类影响执行防护行为的决定因素。美国国立心肺血液研究所（NHLBI）制定了一个研究质量评估工具。
最终共有 39 项研究被纳入本分析。其中许多研究是在发展中国家进行的。对防护措施有影响的最重要因素包括各种社会人口特征（年龄、性别、教育程度、收入、农业经验、农药使用经验）、个体水平（知识、态度、风险感知、意图）、人际水平（主观规范）、组织水平（教育）和公共政策水平（政府关注、健康成本、政府推广服务）。大多数研究的质量是公平的。
研究表明，有几个因素影响农民使用个人防护设备和安全处理农药的行为。这些因素包括农民的教育程度、对安全措施的知识和态度。环境因素，如获得信息、推广服务、培训计划和媒体报道，也有助于最大限度地减少接触农药。
