Pesticide safety behavior and associated factors among farmers in Northwest Iran

Abstract

Pesticide use in Iran is a long-lasting environmental and health concern. A cross-sectional study was carried out during the 2024 growing season among 352 cucumber farmers in Kosar and Khalkhal Counties, northwest Iran. Data were gathered using a validated structured questionnaire that assessed various aspects, namely: pesticide handling practices, personal protective equipment (PPE) use, knowledge, perceived barriers, training exposure, and acute health symptoms. Safe behavior was evaluated using a five-stage model, and multiple linear regression analysis was performed to identify factors associated with safety behavior. An 10.2% (95% CI 6.5–14.8%) of farmers demonstrated safe pesticide-handling behavior, and only 6.0% consistently used PPE, a figure significantly lower than the rate reported across low- and middle-income countries. Acute pesticide-related symptoms affected 76.7% of farmers and 89.5% of household members or workers in Kosar and Khalkhal Counties, a figure more than twice the pooled global estimates. Knowledge of safety practices was the strongest independent predictor (standardized β = 0.350, p < 0.001), followed by training participation (β = 0.155, p = 0.016) and perceived barriers (β = 0.157, p = 0.012). Despite 58% having received training, only 22.7% demonstrated adequate knowledge. Cost and limited availability were the main barriers to PPE use. Northwest Iran emerges as a high-risk area for pesticide-related health issues. Urgent comprehensive actions are needed, including experiential Farmer Field School programs, PPE subsidies, behavioral nudges for low-literacy populations, and mobile units for treatment of poisoning.