factors influencing safety pesticide use behavior …
TRANSCRIPT
FACTORS INFLUENCING SAFETY PESTICIDE USE BEHAVIOR AMONG
FARMERS IN THAI NGUYEN PROVINCE, VIETNAM
HOANG TRUNG KIEN
A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS
FOR THE MASTER DEGREE OF NURSING SCIENCE
(INTERNATIONAL PROGRAM)
FACULTY OF NURSING
BURAPHA UNIVERSITY
AUGUST 2015
COPYRIGHT OF BURAPHA UNIVERSITY
ACKNOWLEDGEMENT
I would like to express my sincere gratitude and deep appreciation to many
individuals who support and encourage me to complete this thesis. First, I would like
to sincerely thank my major advisor, Assistant Professor Dr. Nisakorn Krungkraipetch,
who provided her invaluable input and patience throughout my study. She has been an
enthusiastically advisor who always teaches me the importance of the writing and also
guide me through editing as well as understanding each phase of thesis. I would also
like to thank my co-advisor, Assistant Professor Dr. Chantana Chantawong, for her
comments and suggestions and make my thesis more clear and useful. Great
appreciation is given to all committee members and all experts involved in validating
the instruments.
Great appreciation is also given to the Dean of Faculty of Nursing, Burapha
University, all lecturers and staffs of Faculty of Nursing, Burapha University for
giving me a chance to study in Master of Nursing Science Program in Thailand. For
all the lecturers and staffs in Nursing Faculty of Burapha University, thank you so
much for your support and motivation.
I am very thankful to the president of Thai Nguyen University of Medicine
and Pharmacy and the project program health human resource development under
Ministry of Health, Vietnam, who gave me the great opportunity to study Master of
Nursing Science Program at Faculty of Nursing, Burapha University, Thailand. I also
would like to thank to the head of Vo Tranh and Tan Cuong sub-districts, who gave
me permission and support for data collection to complete my thesis.
Special thank to my parents, older brother for your support. Great respect to
my wife Nguyen Thi Ha for your loving, patience, attention, prayer, and support
through my study in Thailand. Finally, I would like to thanks to all my friends for
your giving kindness, helping and solidarity.
Hoang Trung Kien
iv
56910317: MAJOR: NURSING SCIENCE; M. N. S
KEYWORDS: FARMERS/ PESTICIDES/ SAFETY PESTICIDE USE BEHAVIOR/
INFLUENCING FACTORS/ VIET NAM
HOANG TRUNG KIEN: FACTORS INFLUENCING SAFETY
PESTICIDE USE BEHAVIOR AMONG FARMERS IN THAI NGUYEN,
VIETNAM. ADVISORY COMMITTEE: NISAKORN KRUNGKRAIPETCH,
Dr.P.H., CHANATNA CHANTAWONG, Dr.P.H. 132 P. 2015.
The purposes of this study were to examine safety pesticide use behavior and
determine its associations with gender, education, perceptions, and knowledge of farmers.
A multistage sampling was utilized to recruit the sample of 170 farmers who used
pesticide for their crops. Research instruments included questionnaires for capture of data
regarding demographic characteristics, safety pesticide use behavior, perceived
susceptibility, perceived severity, perceived benefit, perceived barrier, and knowledge of
farmers. Internal consistency reliabilities were .86, .96, .96, .91, .92 and .76, respectively.
Descriptive statistics and stepwise multiple regression analysis were used for data
analyses
The results revealed that most of farmers ranked safety pesticide use behavior
at a moderate level (67.1 %) indicating that these farmers have unsafe pesticide use
behavior. Farmers ranked perceived susceptibility regarding exposure to pesticides at a
low level (M = 2.23, SD = 0.86), perceived severity of consequences from exposure to
pesticides at a low level (M = 2.14, SD = 0.97), perceived benefits of doing safety
behavior at a low level (M = 2.29, SD = 0.76), and perceived barriers to safety behavior
at a high level (M = 2.51, SD = 0.88). Most of farmers were at the medium and low level
of knowledge (74.7%). There were positive significant correlations between knowledge
(β = .54, p < .001), perceived susceptibility (β = .19, p < .01), perceived severity (β = .16,
p < .05) and safety pesticide use behavior. Those factors could explain and accounted for
53% in the variation of the pesticide use behavior (R2 = .53, F[3, 166] = 61.36, p < .001).
These findings suggest that community nurses and health care providers who
work with farmers could increase farmers’ safety pesticide use behavior through
promoting and strengthening their knowledge and perception towards safety pesticide usage.
v
CONTENTS
Page
ABSTRACT .............................................................................................................. iv
CONTENTS ............................................................................................................... v
LIST OF TABLES ..................................................................................................... vii
LIST OF FIGURES ................................................................................................... viii
CHAPTER
1 INTRODUCTION ............................................................................................. 1
Background and significance of the problem ............................................ 1
Research questions ..................................................................................... 5
Research objectives .................................................................................... 5
Research hypothesis ................................................................................... 6
Scope of the study ...................................................................................... 6
Conceptual framework ............................................................................... 7
Definition of terms ..................................................................................... 8
2 LITERATURE REVIEWS ................................................................................ 11
Pesticide ..................................................................................................... 11
Concepts and theories related to pesticide use behavior ............................ 18
Summary .................................................................................................... 37
3 RESEARCH METHODOLOGY ....................................................................... 38
Research design .......................................................................................... 38
Setting of the study .................................................................................... 38
Population and sample ............................................................................... 38
Sampling technique .................................................................................... 39
Research instruments ................................................................................. 42
Translation of the instruments .................................................................... 46
Validity and reliability of the instruments ................................................. 47
Ethical considerations ................................................................................ 47
Data collection procedures ......................................................................... 48
Data analysis .............................................................................................. 49
vi
CONTENTS (continued)
CHAPTER Page
4 RESULTS .......................................................................................................... 50
Part 1 Results of descriptive analysis of sample ........................................ 50
Part 2 Safety pesticide use behavior .......................................................... 68
Part 3 Factors influencing safety pesticide use behavior ........................... 73
5 CONCLUSION AND DISCUSSION ................................................................ 77
Summary of the study ................................................................................ 77
Summary of the findings ............................................................................ 78
Discussions ................................................................................................. 79
Implications ................................................................................................ 84
Recommendation for the future research ................................................... 85
Conclusion ................................................................................................. 86
REFERENCES .......................................................................................................... 87
APPENDICES ........................................................................................................... 99
Appendix A ........................................................................................................ 100
Appendix B ........................................................................................................ 104
Appendix C ........................................................................................................ 108
Appendix D ........................................................................................................ 110
Appendix E ........................................................................................................ 112
BIOGRAPHY ............................................................................................................ 132
LIST OF TABLE
Tables Page
1 Pesticide classification ................................................................................... 13
2 Population and sample size of participants from Tan Cuong and Vo Tranh
sub-district, Thai Nguyen, Vietnam ............................................................... 40
3 Frequency and percentage of farmers by characteristics of participants ....... 51
4 Frequency and percentage of level of knowledge in using pesticides ........... 53
5 Frequency and percentage of components of knowledge in using
pesticides ....................................................................................................... 54
6 Frequency and percentage of level of perceived susceptibility ..................... 55
7 Frequency and percentage of the components of perceived susceptibility ........ 57
8 Frequency and percentage of level of perceived severity .............................. 60
9 Frequency and percentage of the components of perceived severity ............ 61
10 Frequency and percentage of level of perceived benefits .............................. 63
11 Frequency and percentage of the components of perceived benefits ............ 64
12 Frequency and percentage of level of perceived barriers .............................. 66
13 Frequency and percentage of the components of perceived barriers ............. 67
14 Frequency and percentage of level of safety pesticide use behavior ............. 68
15 Frequency and percentage of the components of safety pesticide use
behavior.......................................................................................................... 70
16 The association between modifying factor (gender) and safety pesticide
use behavior ................................................................................................... 73
17 The association between modifying factor (education) and safety
pesticide use behavior .................................................................................... 74
18 Test the mean difference of pesticide use behavior among groups of
education ........................................................................................................ 74
19 The associations between perceptions, knowledge and safety pesticide use
behavior.......................................................................................................... 75
20 The strength of association between significant factors and safety pesticide
use behavior ................................................................................................... 76
LIST OF FIGURES
Figures Page
1 Research framework of safety pesticide use behavior among farmers .......... 8
2 Diagram of health belief model ..................................................................... 26
3 Diagram of sampling process......................................................................... 41
4 Translation of instruments ............................................................................. 46
CHAPTER 1
INTRODUCTION
Background and significance of the problem
Global pesticide consumption has increased 50 - fold every year. There have
been 2.5 million tons (5 billion pounds) of pesticides are used each year (Abrol &
Shankar, 2014). In addition, pesticides are 10 - 100 times more toxic than those used
in the past (Miller & Spoolman, 2012). While developed countries now tend to use
fewer pesticides than before, meanwhile developing countries are tending to use more
(Carvalho, 2006). The amount of pesticide use is rapid growth in the middle and low
income countries, especially in Eastern countries (Schreinemachers & Tipraqsa,
2012). In recent years, herbicides accounted for the largest portion of total use,
followed by other pesticides, insecticides, and fungicides (Environment Protective
Agency [EPA], 2011). In Vietnam, the variety and amount of imported pesticides
were increasing rapidly from 20,300 in 2005 to 72,560 tons in 2010 (Huan, Thiet,
Chien, & Heong, 2005; Ministry of Agricultural and Rural Development [MARD],
2010). The most pesticide use in Vietnam is insecticide (Hoai et al., 2011).
In worldwide, agricultural pesticide use is the highest in many industry
(Cabrera & Leckie, 2013). Farmer who works in agriculture is one of the main groups
of pesticide exposed workers. Previous study suggested that farmers and farm - workers
are at greater risk of pesticide exposure than others workforce (Calvert et al., 2008).
Vietnam has been an agriculture - based country for a long time (Organization for
Economic Cooperation and Development [OECD], 2014). Vietnam's population is
90 million, Vietnamese workforce is 53.86 million (Ministry of Planning and
Investment, 2013). In which 47.8 % of workforce was agricultural workers (General
statistical office, 2011). Vietnamese farmers were also at risk group from exposure to
pesticide (Dasgupta, Meisner, Wheeler, Xuyen, & Lam, 2006).
Pesticides had negative effect on human and environment (Mansour, 2004).
Harmful effect from exposure to pesticides accounted for significant morbidity and
mortality worldwide, especially in developing countries (Kishi & Ladou, 2001). For
farmers, pesticide can cause many problems including acute health effects and chronic
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effects as well as skin disorder, respiratory effect, and effects on the immune, endocrine
and neurological system (Pesticide Action Network [PAN], 2007). As a consequence
from acute and chronic pesticide poisoning, studies in developed countries have
demonstrated the annual incidence rates of acute harmful effect from exposure to
pesticides in agricultural workers to be as much as 18.2 per 100,000 of full time
workers (Calvert et al., 2004). World Health Organization [WHO] (2009 a) estimated
that a minimum of 300,000 people died from pesticide poisoning each year, with
ninety percents of these from low - income and middle - income countries. In globally,
there was 1 to 41 million people who were suffering health effects every year due to
pesticide poisoning (PAN, 2007). Meanwhile in Vietnam, Department of Preventive
Medicine and Ministry of Health reported that there was 4,515 people pesticide
poisoning in recent years, which had 138 deaths from severe pesticide poisoning
(Diep, 2009). It is a warning that pesticide poisoning is increasing in Vietnam today
(Pham, Sebesvari, Tu, Pham, & Renaud, 2011).
Behaviors in using pesticide are most importance factors as determinants of
diseases among farmers (Broucke & Colemont, 2011). Beside, the risk from pesticide
exposure to farmer’s health strongly related with behavior of their pesticide use
(Goldman, Eskenazi, Bradman, & Jewell, 2004; Prado, 2007; Strong, Thompson,
Koepsell & Meischke, 2008). WHO (2001 b) revealed that safety behavior in using
pesticide can prevent health risk from pesticide exposure. It includes using personal
protective equipment, proper transportation, storage, mixing, spraying, avoid leaking
and spilling, proper activities after spraying and disposal.
The farmers still have unsafe behavior in using pesticide. Thus, they exposed
to pesticide in several conditions and many farming activities such as land preparation
for cultivation, storing, mixing, preparing and spraying of pesticides, and loading and
cleaning of spraying equipment (Matthews, 2008). Some studies referred that the
farmers still do not read pesticide labels before pesticide use, mix and load a lot of
pesticides together, do not take care or clean - up the equipment, eat foods or drink
water during application, do not use personal protect devices and storage of pesticide
improperly (Waichman & Nailson, 2007). Moreover, they do not dispose empty
pesticide container take - home exposure properly. This resulted in many farmers got
pesticide via ingestion from food intake, especially vegetables and drinking, water.
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Can cause environment risks, especially the proximity of family homes to farms, spray
drift areas, and the most concern stemmed from their practice (Damalas, Telidis, &
Thanos, 2008; Raksanam, Surasak, Siriwong, & Robson, 2012).
The real situation, pesticide was considered as a threat and the safety
pesticide use behavior viewed as the personal action to reduce threat. From literature
review, there are some research studies regarding factors associated with safety
pesticide use behavior including individual factors, and environmental factors
(Adeola, 2012; Raksanam et al., 2012). Health Belief Model (HBM) mentioned about
decision making to an individual’s perceived ability to choose from alternative health
behavior. Contexts of HBM talked about the desire to avoid illness and the belief that
a specific health action will prevent the illness (Rosentock, Strecher, & Becker, 1988).
Thereby, HBM was used to explain how farmer avoids pesticide exposure and adopt
the safety behavior (Khan, Husnain, Mahmood, & Akram, 2013). The HBM is the
most commonly used theory in health related behavior, especially health education
and health promotion (Glanz, Remer, & Lewis, 2002).
The factors of Health Belief Model were classified as 1) individual
perception including perceived susceptibility, perceived severity; 2) modifying factors
including age, gender, education, knowledge, socioeconomics; 3) Likelihood factors
including perceived benefits and perceived barriers. Factors associated with safety
pesticide use behavior such as age, gender (Zadjali, Morse, Chenoweth, & Deadman,
2014; Lekei, Ngowi, & London, 2014), education, marital status, farming experience,
income (Hou & Wu 2010; Schenker, Marla, Orenstein, & Samuels, 2002),
knowledge, perceptions of farmers (Atreya, 2007; Gupta, Gupta, Pallavi, & Patel,
2012). But age, income, marital status, and farming experiences are not related with
pesticide use behavior or they had weak correlation with safety pesticide use behavior.
These findings may be explained that the sample was homogeneous in age, income,
marital status, and farming experiences. The roles of age, income, marital status and
farming experience are still being debated (Schenker et al., 2002; Tijani, 2006).
Thus, in this study, researcher will focus on factors including gender, education,
knowledge in using pesticide, perceived susceptibility to expose to pesticide, perceived
severity of consequences from exposure to pesticide, perceived benefits of adopting
safety pesticide use behavior, and perceived barriers to adopt safety pesticide use
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behavior due to its strong correlation with safety pesticide use behavior (Ibitayo, 2006;
Khan et al., 2013; McCauley, Shapiro, Scherer, & Lasarev, 2004; Raksanam, Suklim,
& Songthap, 2013; Salvatore et al., 2009).
Gender was found to be related to safety pesticide use behavior. There was
the difference behavior in using pesticide between male and female. Female farmers
were significantly more likely than male farmers to wear clean work clothes, to use
gloves, to wash hands with soap, and to both use gloves and wash hands with soap
(Salvatore et al., 2009; Strong, Thompson, Koepsell, & Meischke, 2008). Apart from
gender, pesticide use behavior is related by education. The high levels of exposure to
pesticides are associated with educational levels (Ibitayo, 2006; Ngowi, Mbise, Ijani,
London, & Ajayi, 2007; Recena, Caldas, Pires, & Pontes, 2006; Salameh, Baldi,
Brochard, & Saleh, 2004). High educated farmers and farmers with high knowledge
were more likely to report practicing equipment calibration and high - educated
farmers were less likely to report storing pesticides in their homes (Lekei et al., 2014).
There were positive statistically significant correlations between knowledge and
pesticide use behavior scores; and overall belief and behavior scores (McCauley et al.,
2004; Kumari & Reddy, 2013; Raksanam et al., 2013).
Perceptions of farmer in safety pesticide use behavior as well as perceived
susceptibility to expose to pesticide and perceived severity of consequence from
exposure to pesticides, perceived benefits of adopting safety pesticide use behavior,
perceived barriers to adopt safety pesticide use behavior were associated with safety
pesticide use behavior (Raksanam et al., 2012). The results showed that the more
perceived susceptibility to expose to pesticide, perceived severity of consequence
from exposure to pesticide, perceived benefit of adopting safety pesticide use
behavior, the more likely farmers were to report a good behavior. However, studies
indicated that the more perceived barrier to adopt safety pesticide use behavior, the
less likely farmers were to report a good pesticide use behavior (Khan et al., 2013;
Raksanam et al., 2013; Strong et al., 2008; Toan, Sebesvari, Bläsing, Ingrid, &
Renaud, 2011).
In conclusion, there are many studies conducted in the Western countries
(Zadjali et al., 2014; Mohanty et al., 2013; Salameh et al., 2004) and in some Asian
countries (Atreya, 2007; Markmee, 2005). Most of these investigations have been
5
conducted outside Vietnam. Moreover, studies in Vietnam focused on kind of
pesticide used in agriculture, harmful effects from pesticide for farmers and policy in
managing pesticides (Dung & Dung, 2003; Hoi, Mol, & Oosterveer, 2013; Huan,
Mai, Escalada, & Heong, 1999). Added to that, few study conducted in safety
pesticide use behavior, and in whole process of pesticide use such as preparation before
spraying pesticide, while spraying pesticide and after spraying. The studies about
pesticide use behavior are limited in Vietnam. It still remains a big gap of knowledge
regarding safety pesticide use behavior and its associated factors among farmers in
Vietnam, especially in Thai Nguyen where is one of the largest region of tea and rice
cultivation and farmers play a crucial role in the socioeconomic development (Thai
Nguyen News, 2014). Therefore, understanding pesticide safety behavior and factors
related to safety pesticide use behavior is basis for community nurse in helping
farmers maintain their safety behavior or stop unsafe behavior. Beside, community
nurses increase the farmer’s knowledge and perceptions by health education and
counseling. For the policies, results of this study will be published to policy maker of
governmental organization to launch some helpful projects which not only promote
safety pesticide use practice among the farmers but reduce health hazardous effect
from pesticide exposure also.
Research questions
1. What are safety pesticide use behaviors among farmers in Thai Nguyen,
Vietnam?
2. Which factors related to the safety pesticide use behavior among farmers
in Thai Nguyen, Vietnam?
3. Which factors influencing safety pesticide use behavior among farmers in
Thai Nguyen, Vietnam?
Research objectives
1. To describe safety pesticide use behaviors of farmers in Thai Nguyen,
Vietnam.
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2. To examine the relationships between modifying factors (gender,
education, knowledge), perceptions (perceived susceptibility to expose to pesticide,
perceived severity of consequence from exposure to pesticide, perceived benefits of
adopting safety pesticide use behavior, perceived barriers to adopt safety pesticide use
behavior) and safety pesticide use behaviors among farmers in Thai Nguyen, Vietnam.
3. To determine the influencing factors of safety pesticide use behavior
among farmers in Thai Nguyen, Vietnam.
Research hypothesis
The hypotheses for this study are as follow:
Hypothesis 1 Farmer’s modifying factors (gender, educational level and
knowledge in using pesticide) are related to safety pesticide use behavior.
Hypothesis 2 Farmer’s perceptions (perceived susceptibility, perceived
severity, perceived barriers) are related to safety pesticide use behavior.
Hypothesis 3 Gender, educational level, knowledge in using and perceptions
of farmers can predict safety pesticide use behavior.
Scope of the study
The farmer who used pesticides for the rice and tea cultivation was the
participants of this study. The study was conducted to describe modifying factors,
perceptions of farmer, and to examine the influence of factor of safety pesticide use
behavior of farmers living in two sub - districts of Thai Nguyen province, Vietnam.
170 participants in this study were adult farmers both male and female aged from
18 - 65. Data were collected by interview - questionnaires from February to March
2015 in Thai Nguyen. The variables in this research including:
1. Independent variables were gender, educational level, knowledge in using
pesticide, perceived susceptibility to expose to pesticide, perceived severity of
consequence from exposure to pesticide, perceived benefit of adopting safety pesticide
use behavior, and perceived barrier to adopt safety pesticide use behavior in this study.
2. Dependent variable was the safety pesticide use behavior.
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Conceptual framework
The Health Belief Model (HBM) was particularly useful for the study of
farmer pesticide safety behavior because of its simplicity and parsimony. This model
mentioned about the behavior and belief especially in prevention disease. The behavior
was viewed as a function of a person’s subjective value of an outcome and his/ her
expectation that a particular health behavior resulted in that outcome. An individual
takes alternative action to prevent disease and protect health when they believe that
they are at risk of illness or disease, they believe the seriousness of illness, believe the
benefits of doing action over the barriers to doing action (Gochman, 1997).
The Health Behavior Model has six key concepts: Perceived susceptibility is
an individual’s belief that he/ she is at risk of an outcome. The relationships of
perceived susceptibility to taking a health action is modified by perceived severity of
the outcome, the perceived benefits of a health behavior to modify the risk of the
outcome, and the perceived barriers to taking action. Beyond these, cues to action can
also modify the relationship of perceived susceptibility to action. Cues to action
include recognized symptoms, knowledge, and education (Gochman, 1997).
The present study, researcher focuses on perceived susceptibility to expose
to pesticide, perceived severity of consequence from exposure to pesticide, perceived
benefits of adopting safety pesticide use behavior, perceived barriers to adopt safety
pesticide use behavior, and modifying factors (gender, educational level, and
knowledge in using pesticide)
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Figure 1 Research framework of safety pesticide use behavior among farmers
Definition of terms
1. The farmers were people who earned their main income from the crop
planting and breeding such as breeding livestock and poultry. The farmers in this
study were the people who plants crops such as rice, and tea on the farms and who
have been using pesticides to protect their crops in Thai Nguyen, Vietnam.
2. Pesticide was defined as organophosphate and carbamate substances or
mixture of its compound used to kill, to reduce or repel many types of pests in rice and
tea farms.
3. Safety pesticide use behavior referred to safety practice performed by the
farmers in preparation before application of pesticides, during application of pesticides
and activities after application of pesticides. It includes proper transportation, the
Independent variables Dependent variable
Modifying factors
- Gender
- Education
- Knowledge in using pesticide
Safety pesticide
use behavior
Perceptions of individual
- Perceived susceptibility to
expose to pesticide
- Perceived severity of
consequences from exposure to
pesticide
- Perceived benefits of adopting
safety pesticide use behavior
- Perceived barriers to adopt
safety pesticide use behavior
9
direction reading carefully, proper in mixing/ loading, using personal protective
equipments, proper storage of pesticide before spraying. Observation of wind and
spraying pesticide follow the wind direction, using personal protective equipments,
spraying pesticide without strong winds, and strong sunshine time, no eating, drinking
or smoking while spraying pesticide, avoiding leaking/ spilling pesticide on the body
during spraying. Wash the hands and take a bath, change spraying - clothes, properly
wash and clean the sprayer and your clothes, adequate disposal the bottles or pesticide
containers, proper storage of empty pesticide container, proper storage of empty
pesticide container, no re - use empty pesticide container or bottle after spraying.
4. Education was defined as highest level of education of participants who
were completed at the date of survey. Level of education contained primary school,
secondary school, high school, diploma, bachelor and higher level,
5. Knowledge in using pesticide was the memory and understanding of
farmers concerning about the main routes of exposure, harmful effects of pesticide and
safety practice in using pesticides. It was measured by using “Knowledge of farmer”
modified by researcher based on previous studies (Mohanty et al., 2013; Atreya,
2007).
6. Perceived susceptibility to expose to pesticide refers to the belief of
farmers that they are at risk of illness or their opinion of the chance of getting acute
pesticide poisoning in short - term exposure to pesticide or chronic disease in long -
term exposure to pesticide. It was measured by using “Perceptions of farmers”
modified by researcher based on previous study (Khan et al., 2013; Raksanam et al.,
2012; Prasit, Nopporn, Dusit, Sukhontha, & Nawarat, 2010; Grzywacz et al., 2013).
7. Perceived severity of consequences from exposure to pesticide refers to
the belief of farmers about the seriousness of the illness or disease from short and
long - term exposure to pesticide. It was measured by using “Perceptions of farmers”
modified by researcher based on previous study (Khan et al., 2013; Raksanam et al.,
2012; Prasit et al., 2010; Grzywacz et al., 2013).
8. Perceived benefits of adopting safety pesticide use behaviors were
defined as farmers’ belief of the effectiveness or positive consequences of adopting
safety pesticide use behavior. It was measured by using “Perceptions of farmers”
modified by researcher based on previous study (Raksanam et al., 2013; Strong et al.,
10
2008).
9. Perceived barriers to adopt safety pesticide use behaviors were defined as
farmers’ belief of the influences that facilitate of discourage adoption of promoted
safety pesticide use behavior. It was measured by using “Perceptions of farmers”
modified by researcher based on previous study (Raksanam et al., 2012; Khan et al.,
2013; Strong et al., 2008).
CHAPTER 2
LITERATURE REVIEWS
The researcher reviewed an overview about issues related to the study.
Firstly, the concepts of pesticide and health effect of pesticide. Secondly, concepts of
safety pesticide use behavior among the farmers. Finally, the research on factors
influencing to pesticide use behavior is reviewed.
1. Pesticide
1.1 Pesticide definition
1.2 Classification of pesticide
1.3 Pesticide use in Vietnam
1.4 Pesticide exposure and harmful effected
2. Concepts and theories related to safety pesticide use behavior
2.1 Safety pesticide use behavior
2.2 Health belief model and safety pesticide use behavior
2.3 Factors related to safety pesticide use behavior
3. Summary
Pesticide
Pesticide is a common agricultural chemical. It is used not only in developed
countries but also is widely used in developing countries. Pesticides protect crops, but
pesticides can cause adverse impacts on the environment and the health of farmers and
their families. To provide basic knowledge and understanding about pesticide,
researcher would like to clarify the definition of pesticide, classification of pesticide
and how to pesticide affects the body.
1. Pesticide definition
Pesticide is defined and classified by several organizations and individuals
around the world. The health sectors and agriculture sectors defined pesticide as
follows:
The Food and Agriculture Organization has defined pesticide as any
substance or mixture of substances intended for preventing, destroying, or controlling
12
any pest including vectors of human or animal disease, unwanted species of plants or
animals, causing harm during or otherwise interfering with the production, storage,
transport, or marketing of food, agricultural commodities, wood and wood products or
animal feedstuffs, or substances that may be administered to animals for the control of
insects, arachnids, or other pests in or on their bodies. Also used as substances applied
to crops either before or after harvest to protect the commodity from deterioration
during storage and transport (Food and Agriculture Organization [FAO], 2002).
Environmental Protection Agency of United States mentioned that pesticide
was defined as any substance or mixture of substances intended for: preventing,
destroying, repelling, or mitigating any pest. Pesticides are designed to (in most cases)
kill pests, but many pesticides can also pose risks to people (EPA, 2011).
The definition of pesticide in the “International Code of conduct on the
Distribution and Use of Pesticide” as follow: Pesticide means any substance or
mixture of substances intended for preventing, destroying or controlling any pest,
including vectors of human or animal disease (WHO, 2006 a).
In this study, Pesticide was defined as organophosphate and carbamate
substances or mixtures chemical used to kill, to reduce or repel many types of pest in
rice and tea farms.
2. Classification of pesticide
Pesticides can be classified in many different ways: according to the target
pest, the chemical structure of the compound used or the degree or type of health
hazard involved (WHO, 2006 a).
Classification by hazard: The objective of classification by hazard is to
enable persons handling and using the pesticide to take appropriate precautions to
minimize exposure. The classification used in many countries is the World Health
Organization recommended classification of pesticides by hazard. Active ingredients
(technical grand) of pesticides are classified as follows:
Ia = extremely hazardous
Ib = highly hazardous
II = moderately hazardous
III = slightly hazardous
O = unlikely if used safely
13
Table 1 Pesticide classification
Class LD50 for the rat (mg/ kg body weight)
Oral Dermal
Solids Liquids Solids Liquids
Ia Extremely hazardous 5 or less 20 or less 10 or less 40 or less
Ib Highly hazardous 5 - 50 20 - 200 10 -100 40 - 400
II Moderately hazardous 50 - 500 200 - 2000 100 - 1000 400 - 4000
III Slightly hazardous Over 500 Over 2000 Over 1000 Over 4000
Classification according to the type of pest they are active against. In
general, we can classify agricultural pesticides into 6 categories (WHO, 2006 b) as
follow insecticide (contains organophosphate, carbamate, organochlorine, minor
types - groups of this insecticide include quinones and phenols), herbicides, fungicides,
algicide, rodenticides, and nematocide (worm killers).
3. Pesticide use on rice and tea farm in Vietnam
In Vietnam, the majority of farming household cultivations is rice and tea
(47 % rice and tea, 18 % rice and tea with some additional vegetables and/ or maize,
18 % only tea, 13 % only rice, 4 % other crop - mixture) (Hoai Zita, Minh, Viet, &
Fabrice, 2011). Vietnamese farmers used many kinds of pesticides on rice and tea
farm. For paddy rice, more than 80 % pesticides applying in rice field was insecticide.
The most widely used insecticides were conphai 15WD and ofatox 400EC,
containing the active ingredients imidacloprid (a neonicotinoid pesticide), fenitrothion
(organophosphate) and trichlorfon (organophosphate), respectively. In addition,
organochlorine pesticides, trichlorfon, fenobucarb, cyfluthrin, and cypermethrin were
applied in tea cultivation (Van-Mele & Van-Lenteren, 2001). Carbamates and
organophosphate compounds are the most used pesticides in Vietnam and the trend to
use them was rapidly increasing (Berg, 2001; Huan et al., 1999; Toan et al., 2013).
Especially, both of them were used on rice and tea farm in mountainous
province of north in Vietnam (Hoai et al., 2011; Toan et al., 2013). But some types of
pesticides have been used in agriculture. Vietnam although they were banned by the
Ministry of Agriculture and Rural Development due to their toxicity. Based on the
14
World Health Organization [WHO] classification of pesticides, farmers used mostly
insecticides in categories I and II, which are classified as moderately and extremely
hazardous, respectively. These include methyl parathion and methamidophos
(organophosphate compounds) which belong to WHO’s category Ia and Ib (extremely
and highly hazardous) respectively, and endosulfan (ogranochlorine compound)
belonging to category II (moderately hazardous) (Dung & Dung, 2003). Moreover,
farmers applied pesticides overdose, it was noteworthy that this amount was about
twice the upper dosage recommended by the distributing companies (Lamers et al.,
2013). Thus, rice and tea farmers are facing with improper use of pesticides (too high
dosage and toxicity) (Hoi et al., 2013).
4. Pesticide exposure and harmful effected
4.1 Pesticide exposure
Exposure is the way a person comes into contact with something, if there
is no exposure, there can be no effect. In this case, when a pesticide comes into contact
with a surface or an organism, that contact is called a pesticide exposure (Conant &
Fadem, 2008). For humans, a pesticide exposure means getting pesticides in or on the
body. The main routes of absorption including: through the skin (dermal absorption),
through the respiratory tract or nose (inhalation), and through the digestive tract or
mouth (ingestion). Almost all such casualties can be avoided by protecting or
preventing the entry of agrochemicals into the body. Rates of absorption into the body
differ according to the route of exposure. For instance, absorption is usually higher
after ingestion than after skin exposure. Absorption in the lungs is the most efficient
route and thus most likely to affect health. Absorption through the skin might be the
commonest route, but some pesticides (such as DDT and the pyrethroidds) are
absorbed to only a limited extant through the skin, except in oily formulations
(International Labour Organization [ILO], 1991; Krieger, 2010; Waxman, 1998).
Pesticide exposure through the skin (dermal absorption): If a pesticide comes
into direct contact with the skin, it can pass quickly through the dermis and epidermis
into the blood. This is the most common route of entry into the body, as contamination
of the skin can occur easily and often goes unnoticed. (Jeyaratnam, 1990; ILO, 1991;
WHO, 1985). Such skin contact may be a result of spills or splashes on to the skin
when handling a pesticide, wearing clothes, gloves, hats, boots, or socks contaminated
15
with pesticides, cleaning or handling equipment that has pesticide on it, and, being
accidentally sprayed either directly or by spray drifting from the next field. Add to that
the danger of pesticides entering through the skin is greatest when the temperature is
high, the skin is wet, or the skin is broken (cuts, sores).
Pesticide exposure through the digestive tract or mouth (ingestion): When
pesticides are taken directly into the mouth and swallowed, they enter the body from
the stomach and intestines (Jeyaratnam, 1990; ILO, 1991; WHO, 2001 a, 1985).
While most people would not intentionally eat or drink a pesticide, they may do so
by consuming food or drink that have been contaminated by spills of pesticide or by
being stored near pesticides; consuming food or drink that has been prepared or
stored in empty pesticide containers; handling and eating food with hands that are
contaminated with pesticide; touching the mouth with contaminated hands.
Pesticide exposure through the respiratory tract (inhalation): Pesticide that is
present in the air is breathed into the lungs. The pesticide passes from the lungs into
the blood and is then carried all over the body (Jeyaratnam, 1990; ILO, 1991; WHO,
1985). Lung contact may occur during mixing and preparation of pesticides for
spraying, during spraying, or when entering a treated area before the dust settles or the
spray dries.
4.2 Health effect of pesticide
Exposure to pesticide resulted in acute and long - term effects, acute and
long-term effects are used to describe the harmful effect of a pesticide on the body.
Acute harmful effect from exposure to pesticides: Acute harmful effect is an
adverse effect occurring within a short time of administration or absorption of a single
or repeated dose given within a short time, the effect is either immediate or would
appear within a day or two after exposure. Although the acute condition can be
directly related to the pesticides, the user may not be aware of this. The symptoms
may appear as a general feeling of sickness, skin irritation or sudden and otherwise
unexplained serious illness (ILO, 1991; Krieger, 2010; Waxman, 1998). In Vietnam,
there were over 35 % of farmers had acute pesticide poisoning experience (a reduction
of AChE > 25 %) (Dasgupta et al., 2007).
Signs and symptoms including nervous/ sensory (headache 39 %, dizziness
22 %, muscle weakness 7 %), gastrointestinal (nausea 33 %, vomiting 18 %,
16
abbominal pain 11%), ocular (irritation/ pain 34 %, lacrimation 14 %), dermatologic
(pruritis 18 %, rash 17 %, erythema 11 %), respiratory (upper respiratory 20 %,
dyspsea 12 %, cough 9 %), cardiovascular (chest pain 4 %, tachycardia 1 %) (Calvert
et al., 2008; Thundiyil, Stober, Besbelli, & Pronczuk, 2008). In Vietnam, Dung and
Dung (2003) revealed that 69.7 percent of the farmers were quite sure of the acute
effect from pesticide exposure. Dasgupta et al. (2007) showed that the most
commonly reported symptoms were dermal (skin irritation: 66 %), neurological
(headache: 61 %; dizziness: 49 %), ocular (eye irritation: 56 %), and respiratory
(shortness of breath: 44 %). Other studies in Vietnam report similar findings for self -
reported ailments. In a study of 369 tea farmers, Diep (2009) report similar incidence
rates for headaches (44 %), nausea (15 %), skin irritation (58 %) and dizziness (24 %).
Dung and Dung (2003) in a study of 2000 pesticide applicators report an incidence of
headaches (60 %) and dizziness (27 %)
4.2.1 Long - term harmful effects from exposure to pesticide
Some pesticides can cause long - term effects after exposure to single
or multiple doses or repeatedly to low concentrations. Long - term effect resulted in
cancer, reproductive, toxic hepatitis, endocrine disruption, neurotoxicity/ damage to
the nervous system, damage to the lungs, damage to the liver and immune toxicity/
damage to the immune system (ILO, 1991; Krieger, 2010; Waxman, 1998).
Many long - term effects of pesticides are hard to see because people in
farming areas are exposed to many different chemicals and because farm workers may
move from place to place (Conant & Fadem, 2008). In Vietnam, there were over 21 %
of farmers had chronic poisoning experience (> 66 % AChE reduction) (Dasgupta et
al., 2007).
Pesticide poisoning from main substances exposure: Organophosphates and
Carbamates are like nerve gas: they attack the brain and nervous system, interfering
with nerve signal transmission. Symptoms include headaches, nausea, dizziness,
vomiting, chest pain, diarrhea, muscle pain and confusion. In severe poisoning
incidents, symptoms can include convulsions, difficulty breathing, involuntary
urination, coma and death (Californians for Pesticide Reform [CPR], 2014).
Organophosphate Pesticide Poisoning: Organophosphates are the basis of
many insecticides, herbicides, and nerve agents. Organophosphates are very highly
17
acute toxic to bees, wildlife, and humans (EPA, 2012). According the pesticide
classification of WHO (2006 b), organophosphates were categorized in highly
hazardous group (Ia and Ib).
Poisoning by organophosphorus insecticides is one of the commonest from
of pesticide poisoning. It requires immediate treatment. Onset occur 0.5 - 24h after
exposure. Initially, the person feels sick and complains of headache, general weakness
or tiredness. Later, the person begins to sweat and salivate (water at the mouth);
farmers may vomit, have diarrhea and complain of stomach cramps; the pupils
become very small, and the person may mention blurred vision; the muscles twitch,
and the hands shake; breathing becomes bubbly, and the person may have a fit and
become unconscious (Conant & Fadem, 2012; Jeyaratnam, 1990; ILO, 1991; WHO,
1985, 2006 b). According to the degree of the severity of poisoning, the following
signs and symptoms can occur:
Mild: anorexia, headache, dizziness, weakness, anxiety, substernal
discomfort, fasciculations of the tongue, eyelids, and impairment of visual acuity
Moderate: nausea, salivation, bronchorrhoea, lachrymation, abdominal
cramps, diarrhoea, vomiting, sweating, hypertension and muscular fasciculations.
Severe: miosis or mydriasis, non-reactive pupils, dyspnoea, respiratory,
depression, pulmonary oedema, cyanosis, loss of sphincter control, convulsions,
hypotension, coma, bradycardia or tachycardia, cardiac ischaemia, cardiac,
dysrhythmia, hypokalaemia and hyperglycaemia. Acute pancreatitis has also, been
observed. Muscular paralysis may involve the respiratory muscles.
4.2.2 Carbamate pesticide poisoning
The carbamates are esters of carbamic acid. Presently, the volume of
carbamates used exceeds that of organophosphates, because carbamates are considered
to be safer than organophosphates. Carbamate insecticides have the same action as
organophosphorus compounds, but they act much faster and recovery is much faster.
It is still harms for human (WHO, 2006 b).
Person who are applying these compounds and do not take the proper
precautions may feel so ill after a while that they have to stop working. Soon after
exposure ends, they will start to feel better, unless they are still absorbing pesticide
from contaminated skin or clothing. Onset occurs as early as 0.5h after exposure.
18
Initially, the person feels sick and may vomit and complains of headache and
dizziness, tiredness and tightness in chest. Later, the person may begin to sweat and
salivate and mention blurred vision and the muscles may twitch. Rarely, a person may
have a fit and become unconscious (Conant & Fadem, 2012; Jeyaratnam, 1990; ILO,
1991; WHO, 1985, 2006 b).
In conclusion, pesticide is a chemical agriculture that control pests and
increase the amount of agricultural yields. But in contrast, pesticide is harmful with
farmers and their families. Farmers and their families are at risk many diseases and
symptom from exposure to pesticide. Acute pesticide poisoning will occur during 24
hours getting toxic from pesticide and long time exposure to pesticide farmer will get
chronic pesticide poisoning. Moreover, pesticides can entry the body easily via skin,
ingestion, and inhalation. Therefore, understanding and defining pesticide and risk are
not only the cornerstones to reduce the impacts of the environment on health and for
the identification of the protection standards, but also for the design of communication
measures to prevent and reduce risks from exposure to pesticide (Conant & Fadem,
2012; Jeyaratnam, 1990; ILO, 1991; WHO, 1985, 2006 b).
Concepts and theories related to pesticide use behavior
1. Safety pesticide use behavior
The total exposure of a farmer to pesticides is the sum of all exposures
resulting during different working situations in different phases of using pesticide
process (before, during, and after spraying pesticides). No working situation is safe, so
precautions to avoid exposure should be taken (WHO, 2001 b). Broucke and
Colemont (2011) mentioned that the behaviors in using pesticide are most importance
factors as determinants of diseases among farmers. The risk from pesticide exposure
to farmer’s health strongly related with behavior of their pesticide use (Goldman,
Eskenazi, Bradman, & Jewell, 2004; Prado, 2007; Strong et al., 2008). Therefore,
farmers will avoid illness, protect disease, and protect their health by performing
safety pesticide use behavior.
Conner and Norman (1996) define health behavior as any activity
undertaken for the purpose of preventing or detecting disease or for improving health
and well being. Gochman (1997) defines them as behavior patterns, actions and habits
19
that relate to health maintenance, to health restoration and to health improvement. The
author also mentioned that behavior outcome will be determined based on individual’s
perception, individual will act to avoid health problem if they perceived threat of
actions, and perceived benefit or barriers to alternative action. In addition, Raksanam
et al. (2012) mentioned that pesticide use behaviors include self-care practices in
terms of personal health at specific times including before spraying, while spraying,
during storage, transportation, waste management, and health risk management.
WHO (2001) refers that safety behavior in using pesticide can prevent health risk from
pesticide exposure. It includes using personal protective equipment (head protection,
eye and face protection, respiratory protection, protective gloves, protective clothes,
and protective footwear), proper transport (the transport of pesticides is a very delicate
matter and should be done carefully, the vehicle used should guarantee the safe
transportation of cargo, do not transport pesticides with other materials, especially
with food), storage (be sure storage shelves are strong enough, store pesticides out of
the reach of children…), mixing (read the instruction before loading the application,
personal protective equipment should be use, never use hands as scoops…), spraying
(be aware of the wind and do not spray against the wind, the equipment should be
checked and used properly, do not eat, drink or smoke during mixing and loading,…),
avoid leaking and spilling, hygiene after spraying (wash the application equipment
after use, wash the working clothes separately from other clothes, wash working
clothes with other clothes, take a shower, and use soap…) and disposal (follow label
instructions or data sheet to dispose of materials in a correct and safe way, do not
threw it pesticide container in the field or on live…).
In this study, safety pesticide use behavior refers to the safety practice in
using pesticides to avoid health problem before application of pesticides, during
application of pesticide and after application of pesticide. Detail was described as follow:
1.1 Safety pesticide use behavior before applying including:
From theory and literature review, the researcher found that there are
many activities in safety pesticide use behavior before applying, it includes:
Proper in transportation
Read the direction carefully
Proper in mixing/ loading
20
Using personal protective equipments
Proper storage of pesticide
Gloves and eyes protection must be worn when pouring, mixing or loading
pesticides (EPA, 2006; Damalas et al., 2008; Waichman & Nailson, 2007). But in the
fact, There was only 28.3 % had good pesticide use behaviors, followed by 60.6 %
moderate, and 11.1 % poor (Prasit et al., 2010). Farmers do not read the label in
pesticide container and disposal of pesticide waste carefully (Damalas et al., 2008;
Raksanam et al., 2012). Farmer mixed pesticides together without direction on
pesticide labels, there were only 55 % of farmers applying pesticide dose equal to the
recommended dosage instructed on pesticide container labels (Toan et al., 2013;
Tijani, 2006) and while preparing pesticide, farmer used personal protective
equipment such as trousers (60.2 %), hat (40.9 %), mask (36.6 %), gloves (69.7 %)
(Prasit et al., 2010). In response to a question regarding “unsafe behavior” of the
respondents during mixing almost all (97 %) the respondents do not wear gloves or
eye glasses/ goggles or respirators when mixing (Ibitayo, 2006), 98.9 % of farmers did
not wear gloves while 98.4 % did not wear eye glasses or goggles when mixing
pesticides (Tchounwou et al., 2002). During mixing, the concentrated chemical was
poured into the lid of the sprayer or pesticide bottle top and then poured into the
sprayer increasing the risk of spilling (Palis, Flor, Warburton, & Hossain, 2006). For
transportation, most of farmers (88 %) transported the pesticides separately from food.
Only 2 % reported always carrying pesticides at the same time as food and these were
primarily in Africa (Matthews, 2008).
Moreover, the farmers often mixed two or more types of pesticides in
sprayers before application (Toan et al., 2013). In Vietnam, farmers did not read
direction on pesticide’ label, and 3 brands of pesticides or more were mixed together
to kill the brown plant hopper pest, 80 % of applicators wore PPE including long-
sleeved shirt, boots, long pants and gloves. Some wore overalls or a raincoat, a local
initiative. However often they did not wear it and some did not wear boots and some
were observed with bare feet. The pesticides were stored in various locations in and
around the home, for example in Hai Hau they were stored in the kitchen or bathroom
(Pesticide Action Network [PAN], 2010). This situation is the same in China, there
21
were 68 % of farmers also said they used a store outside their house, and opened areas
(Matthews, 2008).
1.2 Safety pesticide use behavior during applying
From theory and literature review, the researcher found that there are
many activities in safety pesticide use behavior during applying, it includes:
Observation of wind and spraying pesticide follow the wind direction
Using personal protective equipments
Spraying pesticide without strong winds, and strong sunshine time
No eating, drinking or smoking while spraying pesticide
Avoiding leaking/ spilling pesticide on the body
For manual spraying, the most essential items are boots or covered shoes, a
long-sleeved upper garment and garment that covered the legs, and a hat (EPA, 2006;
Damalas et al., 2008; Waichman & Nailson, 2007). Farmers also get some problems
in safe behavior during and after applying of pesticide (Malin, 2004; Raksanam et al.,
2012). The study was conducted in 2010 showed that 3.2 %, 2.35 % and 0.6 %
farmers reported always smoking, drinking, and eating while spraying insecticide,
respectively (Prasit et al., 2010). Farmers had a meal near pesticides (29.4 %) and
drinking water near pesticide-treated areas (92.6 %) (Mekonnen & Agonafir, 2002).
Another study showed that in terms of the protective measures taken to minimize the
effects of pesticide exposure, most reported the use of basic requisites including masks
(61 %) and hats (49 %), however, the use of glasses (20 %), gloves (18 %) and shoes
(1.4 %) was strikingly lower (Dasgupta et al., 2007). One-third of males and nearly half
of female farmers do not account wind direction during spraying pesticides (Gupta et al.,
2012).
Dung and Dung (2003) also revealed that only 33.3 % of the farmers used
protection equipment such as cap, mask, and clothing when spraying. Result also
shows that 33 % reported “never” wearing long pants when applying pesticides, 18.1 %
reported wearing long pants sometimes,” while 48.9 % reported wearing long pants
“always” when applying pesticides (Ibitayo, 2006). Farmers also mentioned leaks and
chemical dripping directly on to their backs or from the hose of the sprayer, which
they held with their hands, making them vulnerable to high levels of dermal exposure
(Palis et al., 2006). In China, Yunnan where 92 % had spilled while spraying, farmers
22
in Vietnam had same situation with farmers in Yunnan. The most common reason for a
spillage is the sprayer was too full, resulting in an overflow. The results also show that
a significant number did not heed the wind direction while spraying (PAN, 2010).
1.3 Safety pesticide use behavior after applying including:
From theory and literature review, the researcher found that there are
many activities in safety pesticide use behavior after applying, it includes:
Wash the hands and take a bath
Change spraying - clothes
Properly wash and clean the sprayer and your clothes
Adequate disposal the bottles or pesticide containers
Proper storage of empty pesticide container
No re - use empty pesticide container or bottle
Farmers also got some problems in safety use pesticide behavior after
spraying (Ibitayo, 2006; Damalas et al., 2008). But, from some studies, many farmers
did not perform safety behavior in using pesticides. There were 50.6 % of farmers
reported always immediately taking a shower using soap or bath cream, and 63.1 %
reported always immediately washing hands with soap or bath cream. 8.9 % reported
always, and 30.1 % reported sometimes after spraying pesticide (Prasit et al., 2010).
Tijani (2006) revealed that 68 % of farmers washed clothes after spraying, 62 % did
not wash clothes used in spraying among other clothes, 39 % stated that they changed
clothes after spraying. Hand washing was performed by 59% of the farmers after
application of pesticides. Farmers had un-safety in handling pesticides bottles,
containers (Mekonnen & Agonafir, 2002; Raksanam et al., 2012). A smaller
proportion sold their containers back to the seller or to a waste collector. Disposal in
the open field was the most common method at the study site in Vin Hanh, Vietnam
(56 %), and a smaller percentage (15 %) in Hai Hau (PAN, 2010). Ibitayo (2006) also
showed a high level of unsafe use of pesticides and inappropriate methods of disposal
of empty pesticide containers. Farmers returning to the field immediately after
spraying pesticides, about 44.2 % always discarded pesticide containers at a garbage
dump, and 25.1 % always buried them. About 5.1 % said that they sometimes used the
empty pesticide containers to store foodstuffs (Prasit et al., 2010).
23
Most farmers in Tam Nong (95 %) and Cai Rang (45 %) directly discarded
empty pesticide containers in fields after each application. Empty containers could be
found in the fields such as along the small bunds between rice fields, in irrigation
canals and in the orchards (Toan et al., 2013). Almost all (96 %) farmers in An Long
and 45 % in Ba Lang discarded empty pesticide bags and containers directly in the
fields. After spraying/Spillage, 81 % of the farmers in An Long and 69 % in Ba Lang
cleaned the sprayers in irrigation ditches or ponds within their fields while others
(10 % in An Long and 17 % in Ba Lang) washed the equipment in canals outside the
field. There was 36.2 % used the containers to store drinking water, 21.8 % sell the
empty containers, 12.2 % give them to neighbors, 8.5 % burn or bury them, and 3.7 %
either throw the containers into canal or use the containers to provide drinking water
for domestic and farm animals (Ibitayo, 2006).
In conclusion, safety pesticide behavior refers to the safety practice in using
pesticide performed by farmers in preparation before application of pesticide, during
and after application of pesticides. But, in the fact, farmers had problems with their
behavior, during cultivation and use of pesticides. Most of them had unsafe use in
three phases including before application of pesticides (did not wear gloves, eye
glasses, long-sleeve shirt, long pants, and shoes, did not read direction on label of
pesticide, improper mixing pesticides, transportation of pesticide with material and
food, unsafe storage of pesticide), during application of pesticide (take personal
protective equipment, observe and spray follow wind’s direction, smoking, drinking,
eating during spraying, spill pesticide on the body) and after application of pesticide
(wash the hands, take a bath, change the spraying -clothes, wash spraying - clothes
separate with other clothes, storage empty pesticide container in house, throw away
empty pesticide container and bottle). Especially, many farmer use personal protective
equipment to avoid harm from pesticide but they do not often wear it in Vietnam.
They also use inadequate personal protective equipment (Toan et al., 2013).
2. Health belief model and pesticide use behavior
This part present health belief model and how to apply health belief model in
this study. Beside, researcher would like to describe the factors associated with
pesticide use behavior among farmers based on theoretical model of health belief
model. There are several factors may relate pesticide use, particular causes indentified
24
including modifying factors (gender, educational level, knowledge in using pesticide,
perceived susceptibility to expose to pesticide, perceived severity of consequence
from exposure to pesticide, perceived benefit of adopting safety pesticide use behavior,
and perceived barriers to adopt safety pesticide use behavior.
The Health Belief Model (HBM) was first developed in the 1950s by group
of social psychologists in the United Stated Public Health Service, including Godfrey
Hochbaum, Irwin Rosentock, and Stephen Kegels. The model was developed in an
effort to explain the failure of a free tuberculosis (TB) health - screening program
(Hochbaum, 1956, 1958; Rosentock, 1974; Rosentock et al., 1988) and to explain
patient behavior in response to diagnosed illness, particularly their compliance with
medical regimens ((Becker, 1974; Janz & Becker, 1984). In 1988, self - efficacy was
added to the original of HBM in order to increase its explanatory power (Rosentock et
al., 1988).
Health belief model, social cognitive theory and transtheoretical model were
the first three out of ten theories most often used. Health belief model are not only
currently apply in health behavior research, education practice, but are also valid to
predict or change health behavior (Glanz et al., 2002; Glanz, Rimer, & Viswana,
2008; Painter, Borba, Haynes, Mays, & Glanz, 2008). This theory aimed to explain
the reasons of the people to engage or not in health prevention actions such as
vaccination and screening. Later, this theory evolved to a model to predict illness and
actions related with health (Gochman, 1997). The HBM relates theories if decision
making to an individual’s perceived ability to choose from alternative health behavior
(Rosentock, 1974) and has been used both to explain change and maintenance of
health related behaviors and as a guiding framework for health behavior interventions
(Janz, Champion, & Strecher, 2002).
The HBM assumes that individuals take actions toward health if they
believe harm can be serious, if they believe are susceptible, and if they think they can
overcome the barriers to achieve or maintain health (Strecher, Champion, & Rosenstock,
1997; Glanz et al., 2008). The HBM components include three constructs as follows:
1) individual perceptions; 2) modifying factors; 3) likelihood of action. In the first
construct, variables include perceived susceptibility and perceived severity of
disease. The second construct considers factors that modify decision making,
25
including perceived threat of disease, cues to action, and other variables (age, gender,
ethnicity, personality, socioeconomics, and knowledge). The third construct is an
outcome indicating that a person will do something to improve his health or avoid
illness. This construct is determined by three variables: perceived benefits minus
perceived barriers and perceived threat (perceived threat was combination of
perceived susceptibility and perceived severity of disease) (Gochman, 1997).
Perceived susceptibility refers the belief that one is at risk of an illness is
subjective, or their opinion of the chance of getting a condition of health problem.
This component has been reformulated to include the individual’s of a diagnosis,
personal estimates of re - susceptibility to illness in general (Gochman, 1997).
Perceived severity refers the perception of the consequences of a negative
health condition is also subjective. Beliefs of an illness causing pain, debilitation,
social stigma or death are examples of seriousness perceived and possible social
consequence (such as effects of the condition on work, family life, and social
relations). The combination of perceived susceptibility and severity has come to be
labeled perceived threat (Gochman, 1997; Rosenstock et al., 1988).
Perceived benefit of taking action refers individual’s belief regarding the
effectiveness of the various available actions in prevention and reducing the disease
threat and also dealing with illness. A beneficial alternative is one that is likely to
reduce the severity of a health problem or one’s susceptibility to it. It means individual
who exhibits a high level of belief in susceptibility and severity would not be expected
accept any recommended health action unless that action was perceived as potentially
efficacious (Gochman, 1997; Rosenstocket al., 1988).
Barrier to taking action refers the potentially negative aspects of a particular
heath action or one’s opinion of the tangible and psychological costs of the advised
action. A barrier may act as an impediment to undertaking the recommended behavior.
The individual undertakes a cost - benefit analysis. The negative aspects are the
perceptions that it may be expensive, dangerous (having negative side effects or
estrogenic outcomes), unpleasant (pain, difficulty, or upsetting), inconvenient, time
consuming, and so forth (Gochman, 1997; Rosenstocket al., 1988).
Cues to action means and individual takes action could only be potentiated
by other factors, including external factors that trigger behavior such as education,
26
symptoms, or media messages. Educational attainments are believed to have indirect
effect on behavior by influencing the perception of susceptibility, severity, benefits
and barriers (Gochman, 1997; Rosenstocket al., 1988).
Modifying factors are other variables that can indirectly influence health related
behavior including knowledge levels, age, sex, ethnicity, and socioeconomic factors.
Figure 2 Diagram of health belief model (Modified from Gochman, 1997)
Behavior outcome will be determined based on individual’s perception.
Individual will act to avoid a health problem but they first need to believe they are
personally susceptible to the problem. Second, they need to perceive the severity of
the situation before they will take a particular action. Third, the probability that an
individual will act to improve his or her health is determined by the individual’s
perception of the benefits and barriers to alternative behavior. In addition, health - related
Individual perceptions Modifying factors
Perceived
susceptibility/ severity
of disease
Age, sex, ethnicity,
personality,
socioeconomics, and
knowledge
education
Perceived threat of
disease
Cues to action
symptoms, illness,
media information
Modifying factors
Perceived benefits
minus perceived
barriers to behavior
change
Likelihood of
behavior change
27
behavior is also indirectly influenced by modifying factors. Besides that, cues to
action are another factors must occur to trigger the appropriate health behavior.
The internal stimulus such as symptom of illness or positive psychological will motive
to avoid or engage behavior. External stimulus such as mass media communication,
education is the supported environment or unsupported environment to facilitate or to
inhibit action toward healthy behavior or unhealthy behavior. In this study, behavior
outcome are the pesticide safety behaviors including safe activities before application
of pesticide, during and after application of pesticide. Those behaviors are performed
by farmers based on their perceived susceptibility of consequence from exposure to
pesticides, perceived severity of consequence from exposure to pesticides, perceived
severity of consequences from exposure to pesticide, perceived benefits of adopting
safety behavior and perceived barriers to adopt safety behavior (Gochman, 1997).
In conclusion, the health belief model (HBM), a health behavior theory, was
selected for this study among various other health behavioral theories of health
education and health promotion because the health belief model relates theories of
decision making to an individual’s perceived ability to maintain or choose alternative
behavior. Individual should be the target of programs to control pesticide use behavior
due to individual ultimately make decisions for their behavior based directly on
perception. Moreover, this theory has been thoroughly tested in health interventions, is
the most frequently used theory in studies about pesticide risks, and because the
constructs measuring the perceptions about health risks can be applied to examine the
perceptions about environmental risks, more specifically about pesticide risks, and
because the understanding of these perceptions would help design interventions to
modify behaviors that prevent and reduce exposure to pesticides or other
environmental health threats.
3. Factors related with pesticide use behavior
According literature review, many factor associated with pesticide use
behavior as perceptions of farmer have identified. Numerous studies indicated that
farmer’s characteristic also correlated with pesticide use behavior. The farmer’s
characteristics are gender, educational level, knowledge in using pesticide (Khai &
Yabe, 2012; Strong et al., 2008; Larkin, Thomas, & Hendrika, 2008). In this study,
the researcher will focus on some factors as presented below:
28
3.1 Gender
In a study of Washington farmers (n = 554) conducted by Strong et al.
(2008) showed that pesticide use behavior index scores were positively associated
with female gender (p < 0.01). There was the difference behavior in using pesticide
between male and female. Female farmers, however, were significantly more likely
than male farmers to wear clean work clothes (p < .001), to use gloves (p < .001), to
wash hands (p < 0.05), to wash hands with soap (p < 0.005), and to both use gloves
and wash hands with soap (p < 0.01) (Salvatore et al., 2009). Atreya (2007) showed
that there was the difference between male and female in pesticide use behavior. His
study revealed that there were gender differences regarding care of wind’s direction
during spraying, prior knowledge on safety measures, reading and understanding of
pesticides labels, awareness of the labels and protective covers. Almost all respondents
were aware of negative impacts of pesticide use on human health and environment
irrespective of gender; however, females were at higher risk due to lower level of
pesticide use safety and awareness.
This finding is similar with study of Strong et al. (2008) and Hou and Wu
(2010). Results from study in factors associated with pesticide safety practices in
farm workers showed that gender was associated with pesticide use behavior, especially
associated with taking more precautions (Strong et al., 2008). Schenker et al. (2002)
revealed that male farmers were associated with better use of protection pesticide
(p = .003). This study conducted with 885 farmers use of protective equipment among
California farmers, there were only 59 reported rarely/ never using some protective
equipments. Gloves were most frequently used, with 74 % (n = 655) using gloves more
than half the time, followed by protective clothing (61.2 %, n = 540), a face shield
(56.6 %, n = 500), rubber boots (40.4 %, n = 356) and a cartridge respirator (38.3 %,
n = 338).
In contrast, Khan et al. (2013) indicated that there was no any relationship
between gender and pesticide use behavior. This study had the same finding with
another research, the results show that gender has not influenced their practice on
safety use of pesticides (p = .19) (Kumari & Reddy, 2013).
In summary, gender is a factor related to pesticide use behavior. Male farmer
is more likely to use than female farmer. But females were at higher risk due to lower
29
level of pesticide use safety and awareness. But in some studies, there was no any
relationship between gender and pesticide use behavior.
3.2 Education
Education level was defined as highest level of education of participants
who are completed at the date of the survey. In Vietnam, level of education was
classified in to 6 degrees: non - education, primary school, secondary school, high
school, diploma, and bachelor or higher.
Pesticide use behavior is related by education. The high levels of exposure to
pesticides are correlated with low educational levels, which would preclude the ability
of farmers to follow the hazard warnings developed by the chemical industries and
agencies (Ibitayo, 2006; Ngowi et al., 2007; Recena, Caldas, Pires, & Pontes, 2006).
Having a lower general educational level and getting pesticide information through
oral communication were associated with lower prevention measures (p < .001)
(Salameh et al., 2004). Lekei et al. (2014) showed that high educated farmers and
farmers with high knowledge were more likely to report practicing equipment calibration
(OR = 1.2 and OR = 4.0, respectively) and high - educated farmers were less likely
(OR = 0.3) to report storing pesticides in their homes. Farmers with low education
and low knowledge would be expected to have less awareness of the health and
environmental implications associated with pesticides and more inclined to store
pesticides in their homesteads.
The more educated farmers reported taking more safety clothing than
farmers with less education. The result implied that education exerts a significant
effect on the decision to adopt safety measures (p < .001) (Khan et al., 2013). Another
study in effect of education level on behaviors related to pesticides use, the results
showed that participants who received school education had higher percent of healthy
behavior than those who did not receive any school education. They had a higher
percentage regarding: reading labels on pesticides containers (χ2 = 51.38), mixing
pesticides using gloves (χ2 = 35.86), cleaning sprayer nozzle using a wire (χ
2 =
24.46), washing skin coming in contact with pesticides (χ2 = 38.38), putting a cloth on
nose and mouth during spraying (χ2 = 1.93), washing hands and face (χ
2 = 33.19) and
taking a bath following pesticide application and they had a low percentage of using
pesticide containers at home. While there was no significant difference between those
30
receiving school education and those who did not regarding wearing protective
uniform or special clothes during spraying, changing and washing clothing after
pesticide application and eating or drinking during pesticide spraying.
But in contrast, Zadjali et al. (2014) revealed that questions about frequency
of pesticide use suggested that this was unaffected by education status. When asked to
rate pesticides on a scale of 1 (bad) to 10 (good), high responses were most frequent
amongst non - Farmer Association (FA) farm workers followed by FA member farm
workers and non - FA farm owners. On average FA farm - owners had the lowest
average response, and responses by all groups were unaffected by age or education
status.
3.3 Knowledge about safety practice in pesticide use
In general, knowledge is defined as “the mix of framed experience,
contextual information, values and expert insight that provides a frame-work for
evaluation and incorporating new experiences and information” (Devenport & Prusak,
1998). This study focused on understanding of farmers concerning main routes of
pesticide exposure, harmful effected of pesticide, and safety pesticide use behavior in
Thai Nguyen, Vietnam.
There is a high level of knowledge on negative impacts of pesticides on
human health (Atreya, 2007). Knowledge of the farmers with regard to pesticides
including poisonous (97.2 %), harmful effect to the health of agriculture workers (90.4 %)
and harmful effect to environment (95.2 %) (Recena et al., 2006). In contrast, prior
knowledge on pesticide use safety measures was extremely lacking 63 % of males and
75.8 % of females do not have knowledge on pesticides safety measures such as use of
mask, gloves, aprons, full sleeve clothing. Similarly, there were 47 % of males and 75
% of females could not read and understand the icon of pesticides labels present in
containers. Furthermore, 38 % males and 64.2 % females were not aware of the
pesticides labels (Gupta et al., 2012). Farmers had incorrect knowledge in health
hazardous of pesticide (30 % and 60 % of farmers had incorrect of pesticides affect
human and environment respectively), in main route of entries (farmers had incorrect
knowledge of skin route absorption, mouth route, and nose route were 59 %, 62 %,
and 38 % respectively) (Mohanty et al., 2013). Study in Vietnam indicated that a lot of
people did not have any knowledge about the toxicity and hazards of the pesticides.
31
Despite the fact that 69.9 % of people considered pesticides as toxic products, most of
them reported lacking adequate information, and the majority ignored protective
measures or knew little about them, and more than 50 % cited useless protective
measures (Salameh et al., 2004).
A cross - sectional survey of 102 adolescent farmworkers working in Oregon
conducted by McCauley et al. (2004) examined the association between knowledge,
behavior (using any protection against exposure to pesticides). Knowledge scores were
found to be the most significant predictor of using protective methods (p < .01).
In addition, Suklim, Raksanam, and Songthap (2013) revealed that if the
farmers have good knowledge about the kind of pesticide they use and the health
effects of pesticide, they will prevent risky behavior in pesticide use. There were
positive statistically significant correlations between knowledge (r = .34) and behavior
scores, overall belief and behavior scores (r = .62). In addition, statistically significant
predictive variables associated agrochemical safety behavior were knowledge (β =
.12) and belief on agrochemical use (β = .57). These predictors accounted for 39.80
percents of variance.
Mohanty et al. (2013) also indicated that knowledge was associated with
pesticide safety behavior. Observed results showed that only 42 farmers have good
knowledge ( X = 5, SD = 0.64) and rest 58 of them had poor knowledge ( X = 1.9,
SD = 0.67) and the significant association (p < .05) was observed between good
knowledge and use of protective equipments and the significant association was
observed between knowledge level and safe disposal practices of pesticides by the
farmers. Around 66.7 % of farmers with good knowledge immediately used the
pesticide after buying it. Whereas 62.1 % of farmers with poor knowledge of
immediately using it. The pesticide was stored either in a special storage area or house
by 38 % of farmers out of which majority (57.89 %) had poor knowledge.
Karunamoorthi, Mohammed, and Wassie (2012) showed that the great
majority 174 (99.4 %) farmers had ample awareness about pesticide impact on human
health. However, various hazardous practices have also been, documented. Chi - square
analysis revealed a strong association between the farmer’s educational status and
reported toxicity symptoms (χ2 = 498.2, p < .001). Need to create awareness about
safe usage of pesticide is extremely vital by special orientation programs.
32
Kumari and Reddy (2013) There is a significant correlation (r = .52, p < .01)
between the knowledge score and the practice score on protective measures. Authors
explained the difference between male and female farm - workers with regard to
knowledge and practice on safety use of pesticides, male workers have 82 % of
knowledge and significantly differed from female who have only 79 % of knowledge
but their practice levels have not differed significantly. Irrespective of their knowledge
levels only 50 % of correct measures are followed by both male and female farm
workers (t = 1.962*, p = 1.04)
Zyoud et al. (2010) conducted study in knowledge and practice of pesticide
use among farm workers in the West Bank was completed by 381 farmers. The
majority (97.9 %) of the participants were male. There was a positive significant
correlation (r = .32, p < .001) between the knowledge and safety practice in using
pesticide.
Knowledge is a variable that can moderate the degree of pesticide use
behavior. About 31.1 % farmers had a high knowledge of pesticide use, 50.9 % had a
moderate knowledge of pesticide use and 18.0 % of them had a low knowledge of
pesticide use. The result showed that over 75 % of respondents had correct knowledge
about the entry routes of pesticide into the body. Three well know symptoms were
sore eyes (81.4 %), headache/ dizziness (78.6 %), and weakness (76.9 %), while the
symptoms not so well known were excessive sweating (47.7 %) and infertility/
miscarriage (38.3 %). About 42.0 % and 66.6 % respectively, knew that long - term
exposure to pesticides put them at higher risk of cancer and neurological diseases.
Only 52.6 % knew that pesticide residues can persist in the air. Over 70 % had correct
knowledge of alternative methods to chemical pesticides to control pests. About 80.9 %
answered that they stored empty pesticide containers at home (Prasit et al., 2010).
Finding from multiple studies have been consistent that knowledge is an
important factors of pesticide use, if the farmer has good knowledge about pesticide,
they will prevent risk behavior in pesticide use as well.
3.4 Perception of farmer factors
Perception is a process by which individuals organize and interpret their
sensory impressions in order to give meaning to their environment. (Robbins & Judge,
2013). Behavior outcome will be determined based on individual’s perception
33
(Gochman, 1974). Perception of farmers is also correlated with pesticide use behavior
(Kakaei et al., 2014; Raksanam et al., 2012). In this study, based on Health Belief
Model the research will consider the relationship of between perception and pesticide
use behavior following three parts: perceived threat of pesticide (perceived
susceptibility to expose to pesticide, and perceived severity of consequence from
exposure to pesticide), perceived benefit of adopting safety pesticide use behavior, and
perceived barriers to adopt safety pesticide use behavior.
Perceived threat (perceived susceptibility to expose to pesticide and
perceived severity of consequence from exposure to pesticide): Khan et al. (2013)
revealed that perceived severity of consequence of exposure to pesticide is important
factor in shaping individual’s behavior. This factor is to convince farmers to take more
protection. This evidence suggests that pesticide associated negative health problems
act as a signal to change farmer’s future behavior toward pesticide safety. Therefore,
risk perception of farmer is low and they are less likely to take safety measurement. `
In addition, from the result of Raksanam et al. (2012), there was a positive
statistically significant correlations between perception and behavior (r = .47, p < .001).
A high perceived severity of agrochemical hazards was correspondingly high risk
pesticide use behaviours (β = .59, p < 0.05). Another study showed that perceived
susceptibility of pesticide use were correspondingly pesticide behaviors (β = - .55,
p < 0.05).
According to Palis et al. (2006) showed that perceived threat had a
association with pesticide use behavior. Approximately 25.1 % had low perceived
susceptibility, 46.0 % low perceived severity, 40.6 % low perceived benefits, and
6.3 % high perceived barriers. The result also shows that more than 60 % of respondent
perceived those workers in agricultural occupations and their family members were at
high risk of suffering negative effects from chemical pesticides. About 40 % perceived
that long - term exposure to pesticide and pesticide toxicity put them at high risk of
death. Less than 50 % perceived that using protective equipment against chemicals
while spraying or adhering strictly to pesticide - use instructions, had moderate or low
protective capacity or reduced the risks and dangers of pesticide use. Less than 10 %
perceived that using protective equipment against chemicals while spraying increased
the expense of spraying markedly or caused difficulties working.
34
Another research mentioned that seriousness of health risk is important
factor in shaping individual’s behavior. Individual’s risk perception appeared as an
important factor to convince farmers to take more protection which is in line with
previous literature and theoretical background. Therefore, their risk perception is low
and they are less likely to take safety measures. Thus, this evidence suggests that
pesticide associated negative health problems act as a signal to change farmer’s future
behavior toward pesticide safety. The result is consistent with theory and expectations
(Khan et al., 2013). Strong et al. (2008) showed that Farmers’ beliefs around pesticide
exposure and protective practices are strong endorsement of beliefs related to perceived
health threat of pesticide exposure and perceived benefits of protective practices.
Notably, only 34 % of non - Hispanic Whites agreed that chemicals used in the fields
causes harmful effects in the children of agricultural workers compared to 95 % of
Hispanics. Basing on findings from the research of Grzywacz et al. (2013) stated that
perceived severity was targeted in the first lesson by conveying that research has
linked pesticide exposure with a variety of long - term health outcomes like cancer,
memory and learning impairment, and sterility. Similarly, the fifth lesson targeted
perceived severity by highlighting the link between pesticide exposure and congenital
anomalies in children. Perceived susceptibility was conveyed in several lessons
through descriptions of pesticide residues and activities that showed participants
everyday places children come into contact with pesticides (Alavanja, Hoppin, &
Kamel, 2004; Freeman et al, 2005).
However, Isin and Yildirim (2007) mentioned that farmers perceptions had
little or no impact on how to apply pesticides (R2 = .25, p = .02). In addition, Acury,
Quandt, and Russell (2002) studied the effects of perceived pesticide threat and
perceived pesticide control on behaviors among North Carolina farmers (n = 293) and
found that there was little relationship between perceived threat and pesticide safety
behavior (r = - .33, p < .001). Another study showed that perception and belief
variables were not significantly associated with pesticide exposures prevention
behavior (p = .26) (Salvatore et al., 2009). The perceived severity of pesticide hazards
was not correspondingly pesticide behaviors (p = .64) (Suklim et al., 2013).
Perceived benefits of adopting safety pesticide use behavior: Perceived
benefit of taking action refers individual’s belief regarding the effectiveness of the
35
various available actions in prevention and reducing the disease threat and also
dealing with illness. In this study, perceived benefits of pesticide safety behavior were
defined as farmers’ belief of the effectiveness or positive consequences of adopting
safety pesticide use behavior.
Suklim et al. (2013) revealed that there were positive statistically significant
correlations between perceived benefit and behavior scores (r = .47, p < .001).
Khan et al. (2013) revealed that a farmer will use safety measures only if he believes
that he will be better off by doing so. Analogously, a farmer will use safety measures
only if he believes that positive health benefits of using safety measures (perceived
benefits) are greater than the cost (perceived barriers) of using safety measures. Strong
et al. (2008) showed that Farmers’ beliefs around pesticide exposure and protective
practices are strong endorsement of beliefs related to perceived health threat of
pesticide exposure and perceived benefits of protective practices. The result also
showed that 88.3 % of farmer believed that protecting them - self from chemicals will
allow them to live a healthier life, 98.3 % of farmer believed that doing safety
pesticide use behavior is important to protect their children, and 93.3 % of them also
believed that protective clothing protects them from becoming exposed to farm
chemicals. In addition, from the research about effectiveness of intervention model for
improving pesticide safety behaviors among rice farmers, this paper has analyzed the
level of health belief regarding pesticide use.
But in contrast, Raksanam et al. (2012) showed that perceived benefit of
adopting safety pesticide use behavior were not correspondingly pesticide behaviors
(β = - .82, p = .74)
Perceived barriers to adopt safety pesticide use behavior: Barriers to taking
action refers the potentially negative aspects of a particular heath action or one’s
opinion of the tangible and psychological costs of the advised action. A barrier may
act as an impediment to undertaking the recommended behavior. The individual
undertakes a cost - benefit analysis. In this study, perceived barriers to adopt safety
pesticide use behavior were defined as farmer’s belief of the influences that facilitate
of discourage adoption of promoted safety pesticide use behavior.
Furthermore, most spray operators did not wear appropriate protection
equipments (i.e. special protecting clothing, masks, and gloves) which was often
36
observed at the study sites. Given the hot conditions, the majority of farmers did not
like to use the protection equipment as this made work more cumbersome and
uncomfortable (Toan et al., 2013). However often they do not wear it because they
find it too hot (PAN, 2010). Waichman and Nailson (2007) conducted a survey on 253
farmers, the result showed that 77.6 % of farmers did not read pesticides labels
because that they thought the label was written in a foreign language. Foreign
language was as a barrier to adopt safety pesticide use behavior.
Raksanam et al. (2012) showed that perceived barrier to adopt safety
pesticide use behavior were correspondingly pesticide behaviors (β = - .29, p < .05).
In addition, Suklim et al. (2013) revealed that there were positive statistically
significant correlations between perceived barriers and behavior scores (r = .29,
p < .001). Palis et al. (2006) showed that perceived barriers also affected pesticide use
behavior. Health is closely associated with the notion of balance and equilibrium.
These perceptions lead to their practices showing inadequate protection. Khan et al.
(2013) mention that the decision to use safety measures depends on cost (barriers; e.g.
monetary cost of safety measures and cost of discomfort) which require less use of
safety measures and benefits (improved health) which requires higher use of safety
measures. Strong et al. (2008) referred that not perceiving organizational barriers to
protecting oneself was associated with taking more precautions Hispanics were
significantly more likely than non - Hispanic Whites to be concerned about pesticide
exposure and its harmful effects for themselves and their children, to report that
protective equipment slows down their work, and to perceive organizational barriers at
work to protecting oneself from pesticides. Farmers believing that protective
equipment slow them down and perceiving organizational barriers to protecting
oneself were associated with wearing fewer protective items at work.
But in contrast, Raksanam et al. (2012) showed that perceived barriers to
adopting safety pesticide use behavior were not correspondingly pesticide behaviors
(β = - .16, p = .053). In summary, the perception of farmers were factors associated
with pesticide use behaviors, perceptions of farmer includes perceived susceptibility to
exposure to pesticide, perceived severity of consequence from exposure to pesticide,
perceived benefit of adopting safety pesticide use behavior and perceived barriers to
adopt safety pesticide use behavior.
37
Summary
Farmers in Vietnam are at risk of harmful effect from pesticide in rice and
tea cultivation. Results of acetyl cholinesterase enzyme (AChE) blood test revealed a
high prevalence of pesticide poisoning by organophosphate and carbamate exposure,
where over 35 % of test subjects experienced acute pesticide poisoning (42.5 % AChE
reduction), and 21 % chronically poisoned (46.6 % AChE reduction) (Dasgupta et al.,
2007). Farmers still use the banned pesticide and they use mostly insecticides in
categories I and II (Hoai et al., 2011; Toan et al., 2013; Lamers et al., 2013). In
addition, Vietnamese farmers are facing with many troubles in safety pesticide use
behaviors, Moreover, there was few studies exist that examine safety behavior related
to pesticide use among rice farmers and most of them did not focus on whole process
in using pesticide (safety practice in before application of pesticide, during and after
application of pesticide). On the other hand, according to literature review, many
factors have been identified and associate with safety pesticide use behaviors
including gender, educational level, knowledge in using pesticide, perceived threats of
pesticide (perceived susceptibility to expose to pesticide, and perceived severity of
consequences from exposure pesticide), perceived benefit of adopting safety pesticide
use behavior, and perceived barriers to adopt safety pesticide use behavior. Therefore,
understanding safety pesticide use behavior and factors related to pesticide safety
behavior is basis for nurse in helping farmers identify and describe their problems in
using pesticide. Understanding of safety pesticide use behavior will be useful for the
development of nursing intervention that helps promote safety practice for farmers and
reduces harmful effect from pesticide exposure for them as well as their families. In
addition, the result of this study will support the good information for other health care
providers and community managers in establishing the project or policy on pesticide
safety behavior among farmers.
CHAPTER 3
RESEARCH METHODOLOGY
This chapter presented the research methodology including research design,
study setting, population and sample, instruments, instrument translation, data
collection procedures and data analysis.
Research design
A cross - sectional correlation design was used in the present study to
examine the influencing between safety pesticide use behavior and related factors
among farmers in Thai Nguyen, Vietnam.
Setting of the study
Thai Nguyen province is in the north of Vietnam. Thai Nguyen consists of
two zones (mountain zone and land zone). This study was conducted in Tan Cuong
sub - district (locating in land zone) and Vo Tranh sub - district (locating in mountain
zone), Thai Nguyen, Vietnam. Almost all of farmers got their main income from
planting of the rice or tea cultivation and they have been using pesticides (especially
organophosphate and carbamate) to protect their crops.
Population and sample
Population
Population was the farmers who lived in Tan Cuong and Vo Tranh
sub - district, Thai Nguyen and have been using pesticides (organophosphate and
carbamate) on their crops. Tan Cuong had 5,200 people and there were 1,370 farmers
and Vo Tranh had 2,056 people and there were 420 farmers.
Sample
The sample of this study was the farmers who met the eligible criteria as
following:
1. The age ranged from 18 to 65 years old and able to speak, listen and
understand Vietnamese language.
39
2. Farmers who have been using pesticides.
3. Willing to participate in the study and agree to sign the infromed consent
form.
Sample size
The sample size was conducted by using G*power software in this study.
For multiple linear regression, with a significance level of .05, seven factors, and an
estimated moderate effect size (.15) (Burns, Grove, & Gray, 2013), the result was
about 153 subjects that we need.
Researcher encourages determine the possible attrition rate for study to
ensure an adequate sample size at the completion of study. Researcher might anticipate
a 10 % attrition rate in study and need to obtain a sample of 170 farmers in Tan Cung
sub - district and Vo Tranh sub - district of Thai Nguyen, Vietnam.
Sampling technique
Multistage sampling technique was used to select the sample in this study.
Each step of sampling was described as following:
Step 1 Thai Nguyen province consisted of 2 zones (mountain zone and land
zone). In mountain zone had 5 districts including Vo Tranh, Phu Luong, Dai Tu, Dinh
Hoa, and Dong Hy. The land zone had 3 districts and 1 city including Pho Yen, Song
Cong, Phu Binh and Thai Nguyen city. The researcher selected 2 districts, one district
(Phu Luong district) from 5 districts of mountain zone and another district (Thai
Nguyen city) from land zone by using simple random technique.
Step 2 At the 2 selected districts, the researcher used simple random
sampling technique to select one sub-district (Vo Tranh sub-district) from 24
sub - districts in Phu Luong district and another one (Tan Cuong sub - district) from
Thai Nguyen city.
Step 3 At the sub - district the sample size for the farmers was calculated by
using the fromula of Cochran (1977) as follows:
Of which:
nh = sample in each sub-district
40
Nh = farmer population each district
N = total farmer population from 2 sub-district
n = sample size (170)
Table 2 Population and sample size of participants from Tan Cuong and Vo Tranh
sub-district, Thai Nguyen, Vietnam
Vo Tranh Tan Cuong
42 farmers 128 farmers
The researcher used the simple random sampling to select 42 farmers from
420 farmers in Vo Tranh sub - district and 128 farmers from 1,370 farmers in Tan
Cuong sub - districts.
41
Figure 3 Diagram of sampling process
Hong
Thai
Mountain zone
has 5 districts
- Vo Nhai
- Phu Luong
- Dai Tu
- Dinh Hoa
– Dong Hy
Land zone
has 3 districts & 1 city
- Pho Yen
- Song Cong
- Phu Binh
- Thai Nguyen city
Phu Luong district
has 24 sub-districts and
105,233 people
Thai Nguyen city
has 29 sub-districts
and 330,707 people
Simple random sampling
Tan Cuong sub-district
has 5,200 people of
which 1,300 farmers
Vo Tranh sub-district
has 2,056 people of
which 420 farmers
Simple random sampling
42 farmers
(420 x 170) / (420 + 1,370)
128 farmers
(1,370 x 170) / (420 + 1,370)
170 farmers
Simple random sampling
Thai Nguyen province
42
Research instruments
The questionnaires includes demographic data, knowledge of farmer,
perceptions of farmer and pesticide use behavior.
Part 1 Demographic questionnaire
The questionnaire consist of ten items, it was designed to obtain general
information and characteristic of farmers regarding age, gender, marital status,
education level, farming experience, monthly income, duration of insecticide use in
each year, frequency of using pesticide per month, size of farming area, and how
many farmers in one farmer’s house that use insecticides. The demographic
questionnaire was developed by researcher.
Part 2 Safety pesticide use behavior
The safety pesticide use behavior questionnaire (SPUBQ) was developed by
the researcher based on previous studies (Vung, 2007; Raksanam et al., 2012;
Markmee, 2005; WHO, 2001 a; Janz & Becker, 1984). The SPUBQ measures
individual’s behavior in safety practice before, during and after spraying pesticides.
It including proper in transportation, reading the direction carefully, proper in mixing/
loading, using personal protective equipments, proper storage of pesticide before
spraying. Observation of wind and spraying pesticide follow the wind direction, using
personal protective equipments, spraying pesticide without strong winds, and strong
sunshine time, no eating, drinking or smoking while spraying pesticide, avoiding
leaking/ spilling pesticide on the body during spraying. Wash the hands and take a
bath, change spraying - clothes, properly wash and clean the sprayer and your clothes,
adequate disposal the bottles or pesticide containers, proper storage of empty pesticide
container, proper storage of empty pesticide container, no re-use empty pesticide
container or bottle after spraying.
There are 32 items in the SPUBQ. Each item of the SPUBQ was rated on
four-points Likert’s scale of always done, sometime done, rarely done and never done.
The scoring criteria in positive statements as follow:
Always = 4 scores Sometime done = 2 scores
Often done = 3 scores Never done = 1 scores
Interpretation of safety pesticide use behavior: All individual points were
sum up for a total score, means and standard deviations were calculated. The total
43
scores were ranged from 32 to128, with higher score reflecting better pesticide use
behavior. The range of the score and level of each item in regard to behavior was
divided into three levels as follow:
Score 97 - 128 High
Score 67 - 96 Moderate
Score 32 - 66 Low
Part 3 Perception of farmer
The perception of farmer questionnaires was developed by the researcher
based on previous studies (Khan et al., 2013; Strong et al., 2008; Raksanam et al.,
2012; Markmee, 2005; WHO, 2001 a; Janz & Becker, 1984). The perception of farmer
questionnaires was used to ask the participants about perceived susceptibility to expose
to pesticide, perceived severity of consequences from pesticide exposure, perceived
benefits of adopting safety pesticide use behavior, and perceived barriers to adopt
safety pesticide use behavior. There are total 60 items be divided into 4 dimensions as
follow:
Perceived susceptibility: 18 items
Perceived severity: 16 items
Perceived benefits: 13 items
Perceived barriers: 13 items
1. Perceived susceptibility to expose to pesticide questionnaire (PSuEPQ):
There are 18 items in the PSuEPQ. Each item of the PSuEPQ was rated on four - points
Likert’s scale. The scoring criteria in positive statements as follow:
Very high risky = 4 scores Low risky = 2 scores
High risky = 3 scores Very low risky = 1 scores
Interpretation of perceived susceptibility to expose to pesticide: All
individual points were sum up for a total score, means and standard deviations was
calculated. The total scores was ranged between 18 - 72. The higher score means
higher perceived susceptibility. The range of the score and level of each item in regard
to perceived susceptibility was divided into four levels as follow:
Mean score 3.5 - 4.0 Indicates highest
Mean score 2.5 - 3.4 Indicates high
Mean score 1.5 - 2.4 Indicates low
44
Mean score 1.0 - 1.4 Indicates lowest
2. Perceived severity of consequences from exposure to pesticide
questionnaire (PSeCEPQ): There are 16 items in the PSeCEPQ. Each item of the
PSeCEPQ was rated on four - points Likert’s scale. The scoring criteria in positive
statements as follow:
Very high seriously = 4 scores Low seriously = 2 scores
High seriously = 3 scores Not at all seriously = 1 scores
Interpretation of perceived severity of consequences from exposure to
pesticide: All individual points were sum up for a total score, means and standard
deviations was calculated. The total scores was ranged between 16 - 64. The higher
score means higher perceived severity. The range of the score and level of each item
in regard to perceived severity was divided into four levels as follow:
Mean score 3.5 - 4.0 Indicates highest
Mean score 2.5 - 3.4 Indicates high
Mean score 1.5 - 2.4 Indicates low
Mean score 1.0 - 1.4 Indicates lowest
3. Perceived benefits of adopting safety pesticide use behavior
(PBeASPBQ): There are 13 items in the PBeASPBQ. Each item of the PBeASPBQ was
rated on four-points Likert’s scale. The scoring criteria in positive statements as follow:
Very high benefit = 4 scores Low benefit = 2 scores
High benefit = 3 scores Not benefit = 1 scores
Interpretation of perceived benefits of adopting safety pesticide use behavior:
All individual points were sum up for a total score, means and standard deviations
was calculated. The total scores was ranged between 13 - 52. The higher score means
higher perceived benefits. The range of the score and level of each item in regard to
perceived benefits was divided into four levels as follow:
Mean score 3.5 - 4.0 Indicates highest
Mean score 2.5 - 3.4 Indicates high
Mean score 1.5 - 2.4 Indicates low
Mean score 1.0 - 1.4 Indicates lowest
4. Perceived barriers to adopt safety pesticide use behavior (PBaASPBQ):
There are 13 items in the PBaASPBQ. Each item of the PBaASPBQ was rated on
45
four - points Likert’s scale. The scoring criteria in positive statements as follow:
Strong agree = 4 scores Disagree = 2 scores
Agree = 3 scores Strong disagree = 1 scores
Interpretation of perceived barriers to adopt safety pesticide use behavior:
All individual points were sum up for a total score, means and standard deviations was
calculated. The total scores was ranged between 13 - 52. The higher score means
higher perceived barriers. The range of the score and level of each item in regard to
perceived barriers was divided into four levels as follow:
Mean score 3.5 - 4.0 Indicates highest
Mean score 2.5 - 3.4 Indicates high
Mean score 1.5 - 2.4 Indicates low
Mean score 1.0 - 1.4 Indicates lowest
Part 4 Knowledge of pesticide use
The knowledge of pesticide use questionnaire (KPUQ) was developed by the
researcher based on previous studies (Atreya, 2007; Raksanam et al., 2012; Markmee,
2005; WHO, 2001 a; Janz & Becker, 1984). The KPUQ measures individual’s
understanding about kind of pesticides, routes of exposure, harmful effect of
pesticides and safety practice in using pesticides.
There are 20 items in the KPUQ. Each item of the KPUQ was rated on two-
points dichotomous scale of true or false. The scoring criteria in positive statements as
follow:
Correct answer = 1 score
Incorrect answer = 0 score
The total scores was ranged between 0 - 20 score. Scores of knowledge were
classified into 3 groups by using Bloom’s Theory (Bloom, Engelhart, Furst, Hill, &
Krathwohl, 1956). The scores were sum up and classified by percentage as follow:
Score level
≤ 60 % (0 - 12) low
60 – 80 % (13 - 16) moderate
> 80 % (17 - 20) high
46
Translation of the instruments
The questionnaire was translated from English to Vietnamese language by
back-translation (Cha, Kim, & Erlen, 2007). This cycle was continued until the
culturally equivalent meaning was achieved between the original and target language
version of the instruments. The specific translation procedures were used for this
study was as follow:
Step 1 Two translators translated the English versions into Vietnamese
language (Two Vietnamese language versions).
Step 2 Two Vietnamese language versions was compared to get the agreed
Vietnamese language version.
Step 3 Another translator translated from agreed Vietnamese language
version into English.
Step 4 The original English version and the back translated English version
was compared in order to validate the accuracy of the translation process. The
necessary changes in the Vietnamese questionnaires was made by discussion of all
translator who regarding the culturally equivalent meaning in achieved. The
translation process of this study can be summarized in the figure 4.
Figure 4 Translation of instruments
Translator 1
Translator 2
Discuss with
translators Translator 3
Discuss
with
translators
Original
English
version
Vietnamese
version 1
Vietnamese
version 2
English back -translate
version
Vietnamese
version 3
Compare
Compare
47
Validity and reliability of the instruments
Validity
In this study, the content validity of questionnaires were tested by the
Content Validity Index (CVI). Five experts in nursing and public health in Thailand
examined the content validity, language suitability and criteria for scoring of the entire
questionnaire. The Content Validity Index (CVI) was calculated by S - CVI/ UA
(Universal agreement) approach method (Waltz, Strickland, & Lenz, 2010; Burn,
Grove, & Gray, 2013). The questionnaires were revised based on the comment and
suggestion of these experts. The CVI value of pesticide use behavior, perceptions and
knowledge were 0.98, 0.90, and 0.98 respectively.
Reliability
In this study, the questionnaires were tested for the internal consistency by a
pilot study with 50 farmers in Hong Thai whose had similar characteristics to the
sample. Cronbach’s alpha coefficient and Kuder - Richardson (KR) were tested to
assess the reliability of the remaining instruments. The researcher calculated
Cronbach’s alpha of part 2 (safety pesticide use behavior) and part 3 (perceptions
questionnaires including perceived susceptibility, perceived severity, perceived
benefit, perceived barrier) and Kuder - Richarson of part 4 (knowledge questionnaire).
After applying these formulas, the reliability coefficient for these parts were as follow:
Part 2 Safety pesticide use behavior = .86
Part 3 Perceptions of farmers
Perceived susceptibility to expose to pesticide = .96
Perceived severity of consequences from exposure to pesticide = .96
Perceived benefits of adopting safety pesticide use behavior = .91
Perceived benefits to adopt safety pesticide use behavior =.92
Part 4 Knowledge of farmers in using pesticide = .76
Ethical considerations
This proposal was submitted to the IRB (Institution review boad) Faculty of
Nursing, Burapha University (IRB No. 15 - 01 - 2557, Jan. 21, 2015). After getting
the approval from the committee, the research was conducted. The rearcher explained
48
the aims of the study, research procedure, benefits, and safety of this study to the
subjects before obtaining their consents. Subjects were assured that they can a right to
refuse or withdrew from the study at anytime. Involvement in the study, nothing
harmed to the participants. Anonymity and confidentiality are assured, and no personal
information was disclosed to any other person. All data was stored in a secure place
and was only utilized for the purposes of the research. The results was reported as
group data. No names can be disclosed. No physical examination or interference was
implemented to further investigate patient’s situation.
Data collection procedures
The data collection procedure in this study was perfromed by a researcher as
following:
1. The researcher was submitted a proposal to IRB approval Faculty of
Nursing, Burapha University.
2. The researcher was obtained the permission from the Faculty of Nursing
Burapha University to collect data at Tan Cuong and Vo Tranh sub - district.
3. Base on the approval, the researcher met and explained the purpose and
method of the research to the head of Tan Cuong and Vo Tranh sub - district and the
head of village to explain the purpose of the study as well as data collection method
and got the list name of farmers.
4. The researcher made the appointment with participants and the data was
collected only by the researcher at farmer’s house or meeting house in each village on
everyday from 10.00 A.M. to 12.00 A.M. and 1.00 P.M. to 2.00 P.M. They were
explained in detail the research objectives, data collection procedure, research
procedure, and protection of human subjects, and asked to sign a consent form.
5. The researcher explained the details and interviewed the participants.
6. After finishing data collections, the researcher said thank the participants
for their cooperation the data collection.
7. The researcher checked for the completion of the questionnaire at the end
of each questionnaire. The researcher guided them again completed information if the
questionnaire was incomplete.
49
8. After having the whole information, all the data was immediately checked
for completed by researcher. Data was coded and entered into a computer spreadsheet
and prepared for data analysis procedure by the researcher.
Data analysis
The questionnaires were coded and analyzed by using computer statistical
program. The alpha level for significance was set at .05. The analysis of data
including:
1. The descriptive statistics analysis: mean, standard deviation, range,
percentage, and frequency was used to describe all variables in this study including
modifying factors (gender, education, and knowledge), perceptions of farmer and
safety pesticide use behavior.
2. Stepwise multiple regressions were used to examine the factors
influencing safety pesticide use behavior.
CHAPRER 4
RESULTS
The purposes of this study were to describe safety pesticide use behavior and
tests its relationships with gender of farmer, educational level, knowledge in using
pesticide and perceptions (perceived susceptibility to expose to pesticide, perceived
severity of consequence from exposure to pesticide, perceived benefits of adopting
safety pesticide use behavior, perceived barriers to adopt safety pesticide use
behavior) among farmer in Thai Nguyen province, Viet Nam. This chapter presented
research finding by dividing into three parts as follow:
Part 1 Results of descriptive analysis of sample
1. Personal characteristic of farmers
2. Knowledge of farmers in using pesticide
3. Perceptions of farmers about perceived susceptibility to expose to
pesticides, perceived severity of consequences from exposure to pesticide, perceived
benefits of adopting safety pesticide use behavior, and perceived barriers to adopt
safety pesticide use behavior.
Part 2 Safety pesticide use behavior
Part 3 Factors influencing safety pesticide use behavior
1. Results of univariate analysis examining factors associated with pesticide
use behavior
2. Results of multivariate analysis examining factors influencing pesticide
use behavior
Part 1 Results of descriptive analysis of sample
1. Personal characteristics
The major of participants were male, accounted for (53.5 %) and female
(46.5 %). A half of participants (52.9 %) were in the age from 31 to 40 years old with
mean of 35.15 (SD = 7.44). The major of participant (57.1 %) obtained a primary
school (from grade 1 to 9), followed by high school and higher degree (31.7 %) and
no education (11.2 %). About 78.2 % of farmers were married. Most of participants
51
(55.9 %) had income from 3000,000 to 5000,000 VND. The major of participants had 6
to 10 years in farming (44.7 %). There were 28.8 % and 26.5 % of participant who had
1 to 5 years and greater than 10 years in farming respectively. Most of participant
sprayed pesticides 3 to 5 times per month with mean of 4.96 (SD = 1.21), but there was
27.1 % of participant who sprayed more than 5 times per month. More than a half of
participant (58.8 %) used pesticide for their crops more than 11 months per year but
there was 15.9 % of participant who used pesticide less than 10 months per year. The
average size of farm was 2.01(SD = .76) thousand meter square. Most of farmer’s
house (55.9 %) had two farmers, as shown on table 3.
Table 3 Frequency and percentage of farmers by characteristics of participants (n = 170)
Characteristics Frequency Percentage
Gender
Female
Male
79
91
46.5
53.5
Age (years)
≤ 30
31 - 40
41 - 50
51 - 60
M = 35.15, SD = 7.44, Min = 22, Max = 56
45
90
30
5
26.5
52.9
17.6
2.9
Marital status
Married
Single
Widowed or divorced
133
23
14
78.2
13.5
8.2
Education
No education
Primary school
High school and higher degree
19
97
54
11.2
57.1
31.7
52
Table 3 (continued)
Characteristics Frequency Percentage
Income (VND)/ month
1,500,000 - 2,999,999
3,000,000 - 4,999,999
≥ 5,000,000
32
95
43
18.8
55.9
25.3
Year of farming
1 - 5
6 - 10
≥ 10
M = 8.04, SD = 4.11, Min = 2, Max = 20
49
76
45
28.8
44.7
26.5
Number of spraying per month
< 3 times
3 - 5 times
> 5 times
M = 4.96, SD = 1.21, Min = 3, Max = 8
21
103
46
12.4
60.6
27.1
Number of spraying per year
8 - 9 months
10 - 11 months
> 11 months
M = 10.56, SD = .24, Min = 8, Max = 12
27
43
100
15.9
25.3
58.8
Size of farm (1000 m2)
≤ 1
1.1 - 2.0
2.1 - 3.0
> 3
M = 2.01, SD = .76, Min = 0.80, Max = 3.50
20
86
49
15
11.8
50.6
28.8
8.8
Number of farmer per house
1
2
8
95
4.7
55.9
53
Table 3 (continued)
Characteristics Frequency Percentage
3
M = 2.35, SD = .57, Min = 1, Max = 3
67
39.4
2. Knowledge of farmers in using pesticides
Most of participants had low to moderate level of knowledge in using
pesticides. There were 37.6 % of respondent who had low level and 37.1 % of them
had medium level of knowledge. The rest had high level of knowledge in using
pesticides respectively (25.3 %), as shown on table 4.
Table 4 Frequency and percentage of level of knowledge in using pesticides
Level of knowledge Frequency Percentage
Low (< 60 %)
Medium (60 % - 80 %)
High (> 80 %)
64
63
43
37.6
37.1
25.3
Total 170 100
Table 5 showed the frequency and percentage of the correct answer of
participants. Full mark was 20. Most of farmers had a low level of knowledge about
using personal protective equipments such as worn the proper glasses (32.9 %), worn
the proper hat (34.1 %), worn the proper mask (37.1 %). used bare hands (55.9 %),
and also had low level of knowledge in determining main route of exposure of
pesticide (51.2 %), storing pesticides inside house (53.5 %), and following product
instruction (49.4 %), mixing all pesticides (57.6 %).
54
Table 5 Frequency and percentage of components of knowledge in using pesticides
(n = 170)
Statements Correct answer
Frequency Percentage
1. Main route of exposure to pesticides 87 51.2
2. Pesticide can harm to the human 128 75.3
3. Using bare hands while mixing and spraying 95 55.9
4. Exposure pesticides for long time cause cancer 161 94.7
5. Signs of acute pesticide poisoning 157 92.4
6. Wearing proper hat while mixing and spraying 58 34.1
7. Wearing proper eye-glasses while mixing and
spraying
56 32.9
8. Wearing proper mask while mixing and spraying 63 37.1
9. Wearing T-shirt while mixing and spraying
pesticides
157 92.4
10. Wearing trouser while mixing and spraying
pesticides
151 88.8
11. Spraying pesticides in strong sunlight strong
wind
113 66.5
12. The best method to use pesticide is following the
label
140 82.4
13. The best method to store pesticide 91 53.5
14. The best method to clean the clogged nozzle is
blow it
84 49.4
15. The correct practice of pesticide disposal 140 82.4
16. The correct practice of taking a bath 100 58.8
17. The correct practice of pesticide use is mixing
pesticide
98 57.6
18. Smoking, eating, drinking during spraying 132 77.6
19. The correct practice of pesticide use is re-using 100 58.8
55
Table 5 (continued)
Statements Correct answer
Frequency Percentage
20. Pesticide are one of the causes of water/ soil
pollution
137 80.6
3. Perceptions of farmers
3.1 Perceived susceptibility
The mean score of level of perceived susceptibility to expose to pesticides
was 2.23 (SD = .86). A half of farmers ranked perceived susceptibility to expose to
pesticides at a low level (50.0 %), as shown on table 6.
Table 6 Frequency and percentage of level of perceived susceptibility
Level of perceived
susceptibility
Frequency
(n = 170)
Percentage
(%)
Highest (3.5 - 4.0) 16 9.4
High (2.5 - 3.4) 38 22.4
Low (1.5 - 2.4) 85 50.0
Lowest (1.0 - 1.4) 31 18.2
Total 170 100
M = 2.23, SD = 0.86, Min = 1.0, Max = 4.0
The mean score of level of perceived susceptibility to expose to pesticide on
each item were mostly at low level (mean score ranged from 1.5 to 2.4), of which
mean score of perception of “if you spray against wind’s direction, you can get
pesticide poisoning” was lowest (M = 1.97, SD = 1.02). Followed by “if you return to
the field immediately after spraying, you can get pesticide poisoning” (M = 2.08,
SD = 1.00), “if you wash hands or take a bath after spraying, you can expose to
pesticide by ingestion and skin (M = 2.12, SD = 1.03), and “if you re - use empty
pesticide containers to store water or foods, you can expose to pesticide by ingestion
56
and skin absorption” (M = 2.14, SD = 1.05). In addition, there were three perceptions
were at high level including “if you mix two or more kinds of pesticide, you could
expose to pesticide by ingestion (M = 2.46, SD = 1.12), “if you throw empty pesticide
in open area, on field and rive or canal, you will make water or soil contamination”
(M = 2.43, SD = 1.07), and “if you mix pesticide without PPE, you can get pesticide
poisoning” (M = 2.41, SD = 1.13), as shown on table 7.
57
Table 7 Frequency and percentage of the components of perceived susceptibility (n = 170)
Perceived susceptibility
How do you feel ……………………………………………………
Perceptions M SD
Very high
risky
High
risky
Low
risky
Very low
risky
n(%) n(%) n(%) n(%)
1. If you carry pesticide with water and foods, you could expose to
pesticide by ingestion
44(25.9) 51(30.0) 44(25.9) 31(18.2) 2.31 1.06
2. If you mixing two or more kinds of pesticide, you could get poisoning 39(22.9) 46(27.1) 40(23.5) 45(26.5) 2.46 1.12
3. If you mixing pesticide without personal protective equipment, you
could get poisoning
40(23.5) 37(21.8) 46(27.1) 47(27.6) 2.41 1.13
4. If you store pesticide inside house (kitchen room, bedroom), you could
expose to pesticide by ingestion, and skin absorption
28(16.5) 35(20.6) 50(29.4) 57(33.5) 2.20 1.08
5. If you spraying against wind’s direction, you could get poisoning 19(11.2) 28(16.5) 52(30.6) 71(41.8) 1.97 1.02
6. If you spraying on strong wind and sunlight, you could get poisoning 33(19.4) 31(18.2) 62(36.5) 44(25.9) 2.31 1.06
7. If you spraying pesticide without personal protective equipments, you
could get poisoning
33(19.4) 32(18.8) 50(29.4) 55(32.4) 2.25 1.11
8. If you smoking cigarette during spraying, you could get poisoning 30(17.6) 33(19.4) 48(28.2) 59(34.7) 2.20 1.10
9. If you eating and drinking during spraying, you could get poisoning 27(15.9) 37(21.8) 46(27.1) 60(35.3) 2.18 1.09
58
Table 7 (continued)
Perceived susceptibility
How do you feel ……………………………………………………
Perceptions M SD
Very high
risky
High
risky
Low
risky
Very low
risky
n(%) n(%) n(%) n(%)
10. If you work with pesticide in long-term 22(12.9) 38(22.4) 57(33.5) 53(31.2) 2.17 1.02
11. If you having a good health 35(20.6) 32(18.8) 47(27.6) 56(32.9) 2.27 1.23
12. If you spilling pesticide on the body, you could expose to pesticide by
skin absorption
29(17.1) 35(20.6) 46(27.1) 60(35.3) 2.19 1.1.
13. If you not washing hand or taking a bath after spraying, you could
expose to pesticide by ingestion and skin
22(12.9) 34(20.0) 56(32.9) 58(34.1) 2.12 1.03
14. If you contact with children directly while wearing-spraying after
work, children could expose to pesticide
33(19.4) 34(20.0) 52(30.6) 51(30.0) 2.29 1.10
15. If you wash spraying-clothes with others, you could expose to
pesticide by ingestion and skin
30(16.7) 42(24.7) 49(28.8) 49(28.8) 2.31 1.07
16. If you throw empty pesticide in open area, on field and rive or canal
make water and soil contamination
33(19.4) 47(27.6) 52(30.6) 38(22.4) 2.43 1.07
17. If you re-use empty pesticide containers/ bottle store water you could
expose to pesticide by ingestion and skin absorption
24(14.1) 34(20.0) 53(31.2) 59(34.7) 2.14 1.05
59
Table 7 (continued)
Perceived susceptibility
How do you feel ……………………………………………………
Perceptions M SD
Very high
risky
High
risky
Low
risky
Very low
risky
n(%) n(%) n(%) n(%)
18. If you return to the field after spraying, you could get poisoning 19(11.2) 35(20.6) 56(32.9) 60(35.3) 2.08 1.00
60
3.2 Perceived severity
The mean score of level of perceived severity of consequences from
exposure to pesticides was 2.14 (SD = .97). Overall, it was found that farmers ranked
perceived severity of consequences from exposure to pesticides at a low level (37.6 %),
as shown on table 8.
Table 8 Frequency and percentage of level of perceived severity
Level of perceived
severity
Frequency
(n = 170)
Percentage
(%)
Highest (3.5 - 4.0) 19 11.2
High (2.5 - 3.4) 36 21.2
Low (1.5 - 2.4) 64 37.6
Lowest (1.0 - 1.4) 51 30.0
Total 170 100
M = 2.14, SD = 0.97, Min = 1.0, Max = 4.0
The mean score of level of perceived severity of consequence from
exposure to pesticide on each item were mostly at low level (mean score ranged from
1.5 to 2.4), of which mean score of perception of “pesticide can cause family burden”
was lowest (M = 1.96, SD = 1.05). Followed by item “pesticide can cause nervous or
sensory problems in short - term effect” (M = 2.02, SD = 1.10), “pesticide can cause
cardiovascular problems in short - term effect” (M = 2.08, SD = 1.18), and “pesticide
can damage to the nervous system in long - term effect” (M = 2.09, SD = 1.11).
Moreover, there was perceptions of “pesticide can cause congenital disease in children
in long - term effect” (M = 2.46, SD = 1.18) at a high level, as shown on table 9.
61
Table 9 Frequency and percentage of the components of perceived severity (n = 170)
Perceived severity
You belief that harmful effect from pesticide exposure……………
Perceptions M SD
Very
Serious
high
serious
Low
serious
Not at all
serious
n(%) n(%) n(%) n(%)
1. Can cause nervous/sensory problems (Headache; weakness etc) in
short-term
29(17.1) 19(11.2) 49(28.8) 73(42.9) 2.02 1.10
2. Can cause gastrointestinal problems (Nausea; Vomiting; Diarrhea etc)
in short-term
40(23.5) 33(19.4) 42(24.7) 55(32.4) 2.34 1.16
3. Can cause ocular problems (Irritation/pain; Lacrimation;
Conjunctivitisetc) in short-term
37(21.8) 30(17.6) 46(27.1) 57(33.5) 2.28 1.15
4. Can cause dermatologic problems (Pruritis; Rash; Erythema;
Irritation/pain etc) in short-term
29(17.1) 27(15.9) 46(27.1) 68(40.0) 2.10 1.11
5. Can cause respiratory problems (Upper respiratory; Dyspsea; Cough
etc) in short-term
34(20.0) 29(17.1) 41(24.1) 66(38.8) 2.18 1.16
6. Can cause cardiovascular problems (Chest pain; Tachycardia etc) in
short-term
34(20.0) 23(13.5) 36(21.2) 77(45.3) 2.08 1.18
7. Can cause cancer in long-term (lungs and liver cancer) 32(18.8) 27(15.9) 51(30) 60(35.3) 2.18 1.11
62
Table 9 (continued)
Perceived severity
You belief that harmful effect from pesticide exposure……………
Perceptions M SD
Very
Serious
high
serious
Low
serious
Not at all
serious
n(%) n(%) n(%) n(%)
8. Damage to the nervous system in long-term (Parkinson's disease,
depression, memory or learning impairment)
28(16.5) 29(17.1) 43(25.3) 70(41.2) 2.09 1.11
9. Damage to the immune system in long-term (allergy) 33(19.4) 17(10.0) 55(32.4) 65(38.2) 2.11 1.12
10. Reducing sperm quality in male farmers 41(24.1) 27(15.9) 30(17.6) 72(42.4) 2.22 1.23
11. Can cause infertility in female farmers 36(21.2) 32(18.8) 41(24.1) 61(35.9) 2.25 1.16
12. Can cause congenital disease in children 47(27.6) 33(19.4) 41(24.1) 49(28.8) 2.46 1.18
13. Can cause economic burden (losing of money for cure, reducing of
farming productivity)
31(18.2) 30(17.6) 41(24.1) 68(40.0) 2.14 1.14
14. Can cause family burden (taking care person with health problems
due to harmful effects from pesticides is take time)
20(11.8) 29(17.1) 45(26.5) 76(44.7) 1.96 1.05
15. Can cause social interaction (can’t work) 34(20.0) 31(18.2) 46(27.1) 59(34.7) 2.24 1.32
16. Can cause water and soil contamination 34(20.0) 30(17.6) 50(29.4) 56(32.9) 2.25 1.11
63
3.3 Perceived benefits
The mean score of level of perceived benefits of safety pesticide use
behaviors was 2.29. The farmers ranked perceived benefits at a low level (54.1 %), as
shown on table 10.
Table 10 Frequency and percentage of level of perceived benefits
Level of perceived
benefits
Frequency
(n = 170)
Percentage
(%)
Highest (3.5 - 4.0) 11 6.5
High (2.5 - 3.4) 47 27.6
Low (1.5 - 2.4) 92 54.1
Lowest (1.0 - 1.4) 20 11.8
Total 170 100
M = 2.29, SD = 0.76, Min = 1.0, Max = 4.0
The mean score of level of benefit of safety pesticide use behavior on each
item were mostly at low level (mean score ranged from 1.5 to 2.4), of which mean
score of perceptions of “spraying pesticide follow the wind’s direction can help you
reduce risk of pesticide” was lowest (M = 1.94, SD = .99). Followed by “taking a bath
after arriving immediately help you maintain your health” (M = 2.04, SD = 1.03),
“washing spraying - clothes separate with others can keep you/ your family in healthy”
(M = 2.06, SD = 1.01), and “avoiding spilling pesticide on body can help you prevent
pesticide poisoning” (M = 2.14, SD = 1.05). However, there were three perceptions
were at high level including “mixing pesticide follow instruction can help you reduce
harmful effects of pesticide” (M = 2.51, SD = 1.13), “carrying pesticide without water
and foods can help you reduce risk of pesticide” (M = 2.45, SD = 1.15), and “wearing
PPE can help you prevent pesticide poisoning during mixing pesticide” (M = 2.43,
SD = 1.16), as shown on table 11.
64
Table 11 Frequency and percentage of the components of perceived benefits (n = 170)
Perceived benefits
How do you feel if you………………………………………………..
Perceptions M SD
Very high
benefit
High
Benefit
Low
benefit
Not
benefit
n(%) n(%) n(%) n(%)
1. Carry pesticide without water and foods help you reduce risk of pesticide 41(24.1) 43(25.3) 37(21.8) 49(28.8) 2.45 1.15
2. Mix pesticide follow instruction help you reduce harmful effects of
pesticide
43(25.3) 45(26.5) 38(22.4) 44(24.9) 2.51 1.13
3. Wearing PPE help you prevent poisoning when mixing 42(24.7) 39(22.9) 39(22.9) 50(29.4) 2.43 1.16
4. Storage pesticide in looked door help you reduce risk of pesticide 31(18.2) 31(18.2) 46(27.1) 62(36.5) 2.18 1.12
5. Spray pesticide follow the wind’s direction help you reduce risk of
pesticide
18(16.0) 25(14.7) 55(32.4) 72(42.4) 1.94 0.99
6. Wear PPE help you prevent poisoning during spraying 40(23.5) 34(20.0) 46(27.1) 50(29.4) 2.38 1.14
7. Not smoking, eating, drinking help you prevent poisoning during spraying 37(21.8) 39(22.9) 47(27.6) 47(27.6) 2.39 1.11
8. Avoiding spilling pesticide on body help you prevent poisoning 23(13.5) 38(22.4) 49(28.8) 60(35.3) 2.14 1.05
9. Wash the hands after spaying immediately help you maintain your health 26(15.3) 44(25.9) 50(29.4) 50(29.4) 2.27 1.05
10. Take a bath after arriving home help you keep your family healthy 21(12.4) 29(17.1) 55(32.4) 65(38.2) 2.04 1.03
65
Table 11 (continued)
Perceived benefits
How do you feel if you………………………………………………..
Perceptions M SD
Very high
benefit
High
Benefit
Low
benefit
Not
benefit
n(%) n(%) n(%) n(%)
11. Change spraying - clothes reducing risk of pesticide for you and your
family
31(18.2) 29(17.1) 54(31.8) 56(32.9) 2.21 1.09
12. Wash spraying - clothes separate with others keep you/ family healthy 19(11.2) 35(20.6) 54(31.8) 62(36.5) 2.06 1.01
13. Inadequate disposal pesticide contains reduce water and soil
contamination
29(17.1) 33(19.4) 48(28.2) 60(35.3) 2.18 1.10
66
3.4 Perceived barriers
The mean score of level of perceived barriers to safety pesticide use
behaviors was 2.51. The farmers ranked perceived barriers at a high level (38.2 %),
shown on table 12.
Table 12 Frequency and percentage of level of perceived barriers
Level of perceived
barriers
Frequency
(n = 170)
Percentage
(n)
Highest (3.5 - 4.0) 22 12.9
High (2.5 - 3.4) 65 38.2
Low (1.5 - 2.4) 61 35.9
Lowest (1.0 - 1.4) 22 12.9
Total 170 100
M = 2.51, SD = 0.88, Min = 1.0, Max = 4.0
The mean score of level of perceived barrier to do safety pesticide use
behavior on each item were mostly at high level (mean score ranged from 2.5 to 3.4),
of which mean scores of perception of “you feel wearing PPE while spraying pesticide
will inhibit your work” was highest (M = 2.79, SD = 1.08). Followed by item “you
feel wearing PPE while mixing pesticide will inhibit your work” (M = 2.76, SD = 1.07),
“you feel that the direction of pesticide too difficult to follow” (M = 2.67, SD = 1.09),
and “you feel wasting the time to spray pesticide follow the wind’s direction”
(M = 12.63, SD = 1.16). In addition, there were six perceptions were at low level. Of
which two perceptions had the mean scores were lowest. They were “you are not
concern to buy the PPE” (M = 2.13, SD = 1.03), and “you do not know how to dispose
the empty pesticide containers or bottles” (M = 2.15, SD = 1.03), as shown on table 13.
67
Table 13 Frequency and percentage of the components of perceived barriers (n = 170)
Perceived barriers
How much do you agree with the following ………………………..
Perceptions M SD
Strong
agree Agree Disagree
Strong
disagree
n(%) n(%) n(%) n(%)
1. You feel no need to transport pesticide without materials and food 48(28.2) 51(30.0) 38(22.4) 33(19.4) 2.67 1.09
2. You feel no need to follow direction of pesticide’s label 47(27.6) 36(21.2) 44(25.9) 43(25.3) 2.51 1.15
3. You feel wear PPE while mixing pesticide inhibit your work 52(30.6) 56(32.9) 32(18.8) 30(17.6) 2.76 1.07
4. You feel have no area to store pesticide in looked area 34(20.0) 39(22.9) 47(27.6) 50(29.4) 2.34 1.10
5. You feel hot to wear personal protective equipments while spraying 32(18.8) 36(21.2) 50(29.4) 52(30.6) 2.28 1.09
6. You feel wear PPE while spraying pesticide inhibit your work 57(33.5) 48(28.2) 38(22.4) 27(15.9) 2.79 1.08
7. You feel waste the time to spray pesticide follow the wind’s direction 55(32.4) 35(20.6) 42(24.7) 38(22.4) 2.63 1.16
8. It save your time to eating, drinking, and smoking nearby pesticide area 37(21.8) 27(15.9) 47(27.6) 59(43.7) 2.25 1.15
9. You feel waste the time to separate spraying-clothes and others 33(19.4) 42(24.7) 43(25.3) 52(30.6) 2.33 1.10
10. You feel no need to take a bath after arriving house 44(25.9) 43(25.3) 41(24.1) 42(24.7) 2.52 1.13
11. You do not how to dispose empty pesticide container/ bottle 22(12.9) 38(22.4) 53(31.2) 57(33.5) 2.15 1.03
12. You are not concern to buy personal protective equipments 21(12.4) 39(22.9) 51(30.0) 59(34.7) 2.13 1.03
13. It save your money to re-use empty container/ bottle to store water or
foods
46(27.1) 39(22.9) 49(28.8) 36(21.2) 2.56 1.10
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Part 2 Safety pesticide use behavior
Overall, it was found that most of farmers ranked safety pesticide use
behavior at a moderate level (67.1 %). It means that the farmers still have unsafe
behavior in using pesticide, as shown table 14.
Table 14 Frequency and percentage of level of safety pesticide use behavior (n = 170)
Level of safety pesticide use behavior Frequency (n) Percentage (%)
Low
Moderate
High
6
114
50
3.5
67.1
29.4
Total 170 100
M = 89.33, SD = 11.72, Max = 128, Min = 32
Table 15 showed the frequencies and percentage of the answer to each
question of respondents. A full mark was 128. The result was described as follow:
Before spraying, the mean score of the safety pesticide use behavior on each
item were mostly at moderate level (mean score ranged from 2.1 to 3.0), of which
mean score of behavior of “wearing goggles or eye glasses to cover hands while
mixing pesticide” was lowest (M = 2.10, SD = .85). Followed by “wearing rubber
glove to cover hands” (M = 2.13, SD = .80), and “wearing long - sleeve shirt to cover
the body when mixing” (M = 2.18, SD = .79). However, there were five behaviors
were at high level including “wearing two or more kinds of pesticide together”
(M = 3.32, SD = .78), “wearing rubber boots to cover foots when mixing pesticide”
(M = 3.26, SD = .83), “carrying pesticide with water and foods” (M = 3.23, SD = .84),
“wearing improper hat to cover head when mixing pesticide” (M = 3.22, SD = .64)
and “wearing trousers to cover legs when mixing pesticide” (M = 3.22, SD = 87).
During spraying, the mean score of the safety pesticide use behavior on each
item were mostly at moderate level (mean score ranged from 2.1 to 3.0), of which
mean score of behavior of “smoking cigarettes nearby pesticide area” was lowest
(M = 2.06, SD = 1.24). Followed by “eating foods or drinking water nearby pesticide
69
area” (M = 2.16, SD = 1.28), and “wearing rubber boots to cover foots” (M = 2.17,
SD = 1.23). In addition, there were four behaviors at high level including “wearing
short - sleeve shirt to cover the body” (M = 3.46, SD = .82), “avoiding spilling
pesticide on the body” (M = 3.27, SD = .88), “blowing clogged nozzle by mouth”
(M = 3.16, SD = .92), and “wearing normal mask to cove mouth and nose” (M = 3.05,
SD = .88).
After spraying, the mean score of the safety pesticide use behavior on each
item were mostly at moderate level (mean score ranged from 2.1 to 3.0), of which
mean score of behavior of “changing spraying - clothes before arriving house” was
lowest (M = 2.49, SD = 1.18). Followed by “re - using the empty pesticide containers
or bottles to store water or foods” (M = 2.56, SD = 1.17), and “washing spraying-clothes
with others” (M = 2.62, SD = 1.22). Moreover, there were two behaviors were at high
level including “taking a bath after arriving house immediately” (M = 3.27, SD = 1.04),
and “store empty pesticide container or bottle in opened door and inside house”
(M = 3.14, SD = 1.04).
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Table 15 Frequency and percentage of the components of safety pesticide use behavior (n = 170)
Behaviors Frequency M SD
Always
done
Often
done
Some
time
done
Never
Done
n(%) n(%) n(%) n(%)
Before spraying
1. Carry pesticide with water and foods 71(41.8) 79(46.5) 8(5.7) 12(7.1) 3.23 .84
2. Read the direction on label 34(20.0) 95(55.9) 34(20.0) 7(4.1) 2.92 .75
3. Mixing two or more kinds of pesticide together 18(10.6) 77(45.3) 63(37.1) 12(7.1) 2.59 .77
4. Wearing normal hat to cover head when mixing pesticide 79(46.5) 76(44.7) 6(3.5) 9(5.3) 3.32 .78
5. Wearing normal mask to cover mouth and nose when mixing pesticide 54(31.8) 104(61.2) 8(4.7) 4(2.4) 3.22 .64
6. Wearing goggles/ glasses to cover eyes when mixing pesticide 8(4.7) 47(27.6) 69(40.6) 46(27.1) 2.10 .85
7. Wearing rubber glove to cover hands when mixing pesticide 8(4.7) 43(25.3) 82(48.2) 37(21.8) 2.13 .80
8. Wearing long - sleeve shirt to cover the body when mixing pesticide 6(3.5) 52(30.6) 78(45.9) 34(20) 2.18 .79
9. Wearing trousers to cover legs when mixing pesticide 71(41.8) 80(47.1) 4(2.4) 15(8.8) 3.22 .87
10. Wearing rubber boots to cover foots when mixing pesticide 76(44.7) 74(43.5) 9(5.3) 11(6.5) 3.26 .83
11. Store pesticide in opened door and inside house 29(17.1) 83(48.8) 44(25.9) 14(8.2) 2.75 .84
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Table 15 (continued)
Behaviors Frequency M SD
Always
done
Often
done
Some
time
done
Never
Done
n(%) n(%) n(%) n(%)
During spraying
12. Spraying follow wind’s direction 41(24.1) 99(58.2) 17(10) 13(7.6) 2.99 .81
13. Spraying only on the windless and less strong sunlight time 40(23.5) 56(32.9) 51(30) 23(13.5) 2.66 .99
14. Wearing normal hat to cover head 34(20.0) 55(32.4) 47(27.6) 34(20.0) 2.52 1.03
15. Wearing normal mask to cover mouth and nose 56(32.9) 81(47.6) 19(12.1) 14(8.2) 3.05 .88
16. Wearing normal glasses to cover eyes 37(21.8) 69(40.6) 31(18.2) 33(19.4) 2.65 1.03
17. Wearing rubber glove to cover hands 39(22.9) 55(32.4) 40(23.5) 36(21.2) 2.57 1.07
18. Wearing long - sleeve shirt to cover the body 61(35.9) 46(37.6) 17(10.0) 28(16.5) 2.93 1.06
19. Wearing trousers to cover legs 103(61) 54(31.8) 2(1.2) 11(6.5) 3.46 .82
20. Wearing rubber boots to cover foots 46(27.1) 7(4.1) 47(27.6) 70(41.2) 2.17 1.23
21. Smoking cigarette near pesticide area 43(25.3) 7(4.1) 38(22.4) 82(48.2) 2.06 1.24
22. Eating food or drinking water near pesticide area 48(28.2) 9(5.3) 35(20.6) 78(45.9) 2.16 1.28
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Table 15 (continued)
Behaviors Frequency M SD
Always
done
Often
done
Some
time
done
Never
Done
n(%) n(%) n(%) n(%)
23. Avoiding spilling pesticide on the body 80(47.1) 71(41.8) 4(2.4) 15(8.8) 3.27 .88
24. Blowing clogged nozzle by mouth 68(47.1) 40(23.5) 0(0.00) 20(11.8) 3.16 .92
After spraying
25. Wash the hands after spraying immediately 81(47.6) 32(18.8) 9(5.3) 48(28.2) 2.86 1.28
26. Take a bath after arriving house immediately 99(58.2) 40(23.5) 9(5.3) 22(12.9) 3.27 1.04
27. Wash spraying - clothes with others 56(32.9) 42(24.7) 23(13.5) 49(28.8) 2.62 1.22
28. Change spraying-clothes before arriving house 47(27.6) 39(22.9) 35(20.6) 49(28.8) 2.49 1.18
29. Store empty pesticide container/ bottle in opened door and inside house 80(47.1) 59(34.7) 6(3.5) 25(14.7) 3.14 1.04
30. Throw empty pesticide containers/ bottle to field or cannel 67(39.4) 42(24.7) 29(17.1) 32(18.8) 2.85 1.14
31. Re-use empty pesticide containers/ bottle store other water or foods 49(28.8) 43(25.3) 32(18.8) 46(27.1) 2.56 1.17
32. Return to the field immediately after spraying pesticide 37(37.6) 62(36.5) 16(9.4) 28(16.5) 2.95 1.66
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Part 3 Factors influencing safety pesticide use behavior
1. Results of univariate analysis examining factors associated with
safety pesticide use behavior.
1.1 Modifying factors
Gender and behavior: The result revealed that significantly association
between the gender of farmers and overall safety pesticide use behavior. An
independent-samples t-test was conducted to compare the behavior scores for males
and females. There was a significant difference in scores for males and females
(t168 = - 3.45, p = .001). The result also indicated that gender was related to pesticide use
behavior, as shown on table 16.
Table 16 The association between modifying factor (gender) and safety pesticide use
behavior.
Gender n Mean SD Mean
difference
t df p
Male 91 86.53 12.15 6.03 3.45 168 .001
Female 79 92.56 10.37
DV = behavior
Education and behavior: There was significantly association between
education and safety pesticide use behavior. A one-way ANOVA analysis of variance
was conducted to compare the behavior scores for three educational levels (group 1:
no-education; group 2: primary school; group 3: high school and higher). The result
revealed that at least one pairs of educational levels had a difference means of safety
pesticide use behavior significantly (F2, 167 = 28.64, p < .001). The result also indicated
that educational levels were related to pesticide use behavior, as shown on table 17.
In addition, the resulted showed that pairs of “No education” and “Primary school” had no
the mean difference of safety pesticide use behavior (p > .05), pairs of “No education” and
“High school and higher degree” had the mean difference of safety pesticide use behavior
(p < .05), and pairs of “Primary school” and “High school and higher” had the mean
difference of safety pesticide use behavior. The finding also indicated that the farmer
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who graduated in high school and higher degree had higher level of safety pesticide use
behavior than farmer who graduated in primary school and no-education. The farmer
who have no education had the same level of safety pesticide use behavior as the one
who graduated in primary school, as shown on table 18.
Table 17 The association between modifying factor (education) and safety pesticide
use behavior.
Source of variation n df MS F p
Between groups 18 2 2965.8 28.64 .000
Within group 100 167 103.6
Total 52 169
DV = safety pesticide use behavior
Table 18 Test the mean difference of pesticide use behavior among groups of education
No education
(M =87.28)
Primary school
(M = 85.10)
High school and
higher degree
(M = 98.18)
No education 2.18 10.90*
Primary school 13.08*
High school and higher degree
*. The mean difference is significant at the 0.05 level.
1.2 Perceptions, knowledge and safety pesticide use behavior
For correlations between perceptions (perceived susceptibility, perceived
severity, perceived benefit and perceived barrier), knowledge and safety pesticide use
behavior, it were found that safety pesticide use behavior was significant and moderate
correlation with perceived susceptibility (r = .50, p < .01), perceived severity (r = .45,
p < .01), perceived benefit (r = .46, p < .01), perceived barrier (r = - .43, p < .01) and
pesticide use behavior use have significant and strong association with knowledge
(r = .67, p < .01). In addition, it was found that the correlation matrix between each
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independent variables were not greater than 0.85 (Burn et al., 2013) that it has not
violated the assumption of multicollinearity, as shown on table 19.
Table 19 The associations between perceptions, knowledge and safety pesticide use
behavior.
1 2 3 4 5 6
1. Safety pesticide use behavior 1.00
2. Perceived susceptibility .50** 1.00
3. Perceived severity .45** .459** 1.00
4. Perceived benefit .46** .681** .588** 1.00
5. Perceived barrier - .43** - .455** - .458** -.454** 1.00
6. Knowledge .67** .422** .346** .455** - .378** 1.00
* = p < .05, ** = p < .01, *** = p < .001
2. Results of multivariate analysis examining factors associated with
safety pesticide use behavior.
Stepwise multiple regression analysis was computed. p - value for variable
entry was .05. Among seven factors related to safety pesticide use behavior including
gender, educational level, perceived susceptibility, perceived severity, perceived
benefit, perceived barrier, and knowledge in using pesticide, there were three variables
which could predict pesticide use behavior. In which, knowledge in using pesticide
was entered into the first model, first model showed that knowledge could significantly
explain behavior and accounted for 45 % of variation in the pesticide use behavior
(R2 = .45, F[1, 168] = 137.17, p < .001). Knowledge and perceived susceptibility to
expose to pesticide were entered into the second model, second model showed that
knowledge and perceived susceptibility to expose to pesticide could significantly
explain behavior and accounted for 51 % of variation in the pesticide use behavior
(R2 = .51, F[2, 167] = 86.64, p < .001). The final model showed that knowledge,
perceived susceptibility to expose to pesticide and perceived severity of consequence from
exposure to pesticide could explain behavior and accounted for 53 % in the variation in
the pesticide use behavior (R2 = .53, F[3, 166] = 61.36, p < .001), as shown on table 20.
76
Table 20 The strength of association between significant factors and safety pesticide
use behavior (N = 170)
Predictors B SE Beta
Knowledge 1.78*** .20 .54*** Intercept = 52.86***
Perceived susceptibility .17** .06 .19** R2 = .53, F(3, 166) = 61.36***
Perceived severity .15* .06 .16*
* = p < .05, ** = p < .01, *** = p < .001
The equation for predicting value of pesticide use behavior could be written:
1. Unstandardized coefficients equation: Safety pesticide use behavior =
52.86 + 1.78(knowledge) + 0.17(perceived susceptibility) + 0.15(perceived severity).
From this equation, it can be implied that for each one unit increases on
knowledge toward safety pesticide use behavior, there was 1.78 times that responds will
get good behavior in using pesticide. One unit increases on perceived susceptibility
toward safety pesticide use behavior, there was .17 times that responds will get good
behavior in using pesticide. One unit increases on perceived barriers toward pesticide
use behavior, there was .15 times that responds will get good behavior in using pesticide.
2. Standardized coefficient equation: Zsafety pesticide use behavior = 0.54(Zknowledge)
+ .019(Zperceived susceptibility) + 0.16(Zperceived severity). It can be implied that knowledge in
using pesticide was the most important variable to predict safety pesticide use
behavior, the second was perceived susceptibility to expose to pesticide and the third
was perceived severity of consequence from exposure to pesticide.
CHAPTER 5
CONCLUSION AND DISCUSSION
The present study aimed to explore safety pesticide use behavior and to
examine factors influencing to those behavior. This chapter presents a summary of this
study’s research methodology and its findings. Discussions of research findings as
well as implication of the findings and recommendations for future research are
presented.
Summary of the study
The purposes of this study were to examine safety pesticide use behavior and
determine its associations between farmer’s gender, education level, knowledge,
perceptions of farmers in using pesticide and safety pesticide use behavior among
Vietnamese farmers in Thai Nguyen. The research design was the cross - sectional
correlation study. Multistage sampling technique was used to recruit the sample of
170 farmers who met the study’s inclusion criteria. Data were obtain through
interview at farmer’s house and meeting house in each village of Tan Cuong and Vo
Tranh districts, Thai Nguyen province, Vietnam. The instruments used in this study
were developed by researcher. There were general information of farmers, safety
pesticide use behavior of farmers, perceptions of farmers and knowledge of farmers.
The Cronbach’s alpha coefficients of safety pesticide use behavior, perceptions
susceptibility, perceived severity, perceived benefits, and perceived barriers were
0.86, 0.96, 0.96, 0.91, and 0.92 respectively. Reliability of knowledge of farmer was
done by using Kuder - Richadson strategy (KR - 20 = 0.76). The questionnaire was
conducted in English language and was evaluated for content validity by five Thai
experts. The CVI value of pesticide use behavior, perceptions and knowledge were
0.98, 0.90, and 0.98 respectively.
78
Summary of the findings
The research results can be summarized as follows:
1. General data of the farmers
There were 170 farmers participated in this study. The most of them was
male (53.5 %). Their ages were mostly in early adulthood. A half of participants
(52.9 %) were in the age from 31 to 40 years old with mean of 35.15 (SD = 7.44).
Most of farmers were married (78.2 %). About 88.8 % of participants completed
general education and higher, whereas 11.2 % of these respondents were illiterate.
For income, most of them (55.9 %) had income at moderate level. There was 71.2 %
of farmers had six years and higher in farming experiences. Most of farmers (87.7 %)
sprayed pesticide three times and more per month. More than a half of participant
(58.8 %) used pesticide for their crops more than 11 months per year but there was
15.9 % of participant who used pesticide less than 10 months per year. The average
size of farm was 2.01(SD = .76) ha. Most of participants (55.9 %) had two people who
were farmer.
2. Descriptive information of study variables
The results from this study showed that the farmers ranked perceived
susceptibility to expose to pesticides at a low level (M = 2.23, SD = 0.86, ranged =
1 - 4), perceived severity of consequences from exposure to pesticides at low level
(M = 2.14, SD = 0.97, ranged = 1 - 4), perceived benefits of doing safe behavior at
low level (M = 2.29, SD = 0.76, ranged = 1- 4), and perceived barriers to safe
behavior at high level (M = 2.51, SD = 0.88, ranged = 1 - 4). The most of farmers had
knowledge at medium and low level (74.7 %). For safety pesticide use behavior, most
of participants ranked their behavior at a moderate level in using pesticide, accounted
for (67.1 %), followed by high level (29.4 %) and low (3.5 %).
3. The relationship between selected factors and safety pesticide use
behavior
Among variables examined by univariate analysis, all variables was had a
significantly association with safety pesticide use behavior. For gender, there was a
significant difference in scores for males and females (t168 = 3.45, p = .001). The
result revealed that at least one pairs of educational levels had a difference means of
safety pesticide use behavior significantly (F2, 167 = 28.64, p < .001). The pairs of “No
79
education” and “Primary school” had no the mean difference of safety pesticide use
behavior (p > .05), pairs of “No education” and “High school and higher degree” had the
mean difference of safety pesticide use behavior (p < .05), and pairs of “Primary school”
and “High school and higher” had the mean difference of safety pesticide use behavior.
The finding also indicated that the farmer who graduated in high school and higher
degree had higher level of safety pesticide use behavior than farmer who graduated in
primary school and no - education. The farmers who have no education had the same
level of safety pesticide use behavior as the one who graduated in primary school. The
safety pesticide use behavior was significant and moderate correlation with perceived
susceptibility (r = .50, p < .01), perceived severity (r = .45, p < .01), perceived benefit
(r = .46, p < .01), perceived barrier (r = -.43, p < .01) and safety pesticide use behavior
had a significant and strong association with knowledge (r = .67, p < .01). But the
result of multivariate analysis showed that there were three significant variables
including knowledge (p < .001), perceived susceptibility (p < .01), perceived severity
(p < .05) and four insignificant variables (gender, educational level, perceived benefit
of adopting safety pesticide use behavior, and perceived barrier to adopt safety
pesticide use behavior). Thereby, the major factors influencing whether a farmer
reported having a safety pesticide use behavior were: knowledge in using pesticide,
perceived susceptibility to expose to pesticide, and perceived severity of consequence
from exposure to pesticide were positive associated with safety pesticide use behavior.
Discussions
1. Safety pesticide use behavior among farmers in Thai Nguyen province,
Vietnam.
For overall, the result showed that farmers ranked safety pesticide use
behavior at a moderate level (M = 89.33, SD = 11.72), accounted for 61.1 %, the rests
were high level (29.4 %) and low level (3.5 %). It means that the farmers still have
unsafe behavior in using pesticide. This finding was similar with the results of most
studies in other countries. Study in Thailand showed that the unsafe behavior,
especially related to the use of improper personal protective equipment, were at a
remarkably high level (Raksanam et al., 2012). In France, researcher revealed that
pesticide use behavior of participant was also observed at low and moderate level
80
(Salameh et al., 2004). Unsafe behaviors were identified as the storage of pesticide
products at home, the preparation of pesticides in the kitchen, inadequate disposal of
empty pesticide containers, eating and drinking during pesticide application, and using
inadequate protective clothing among farmers in Palestine (Zyoud, et al., 2010).
Before spraying, the unsafety pesticide use behaviors were determined as
behaviors of “wearing goggles or eye glasses to cover hands while mixing pesticide”,
(M = 2.10, SD = .85), “wearing rubber glove to cover hands” (M = 2.13, SD = .80),
and “wearing long - sleeve shirt to cover the body when mixing” (M = 2.18, SD = .79).
These findings were similar with another research. Raksanam et al. (2012) also
mentioned that farmers still had unsafe behavior in using pesticide. The result can be
explained because the farmers perceived that they are not susceptible to expose to
pesticide before spraying and mixing pesticide. There was a half of respondents
perceived that they had very low and low opportunity to expose to pesticide if they
mixing pesticide without PPE. In addition, most of them perceived PPE as a barrier
that made them felt hot or inconvenience and inhibited their work. In the other hands,
farmers felt difficult to read, and understand the instruction of pesticide. They mix and
spray pesticide follow their experiences or suggestions of chemical seller and other
farmers. These results was accordance with other researches farmers perceived that
pesticide to them may not be a threat because they are immune, it is regarded as a
medicine that is needed by the plants rather than poison and they believed that worn
PPE would cause Pasma (muggy) (Khan et al., 2013; Palis et al., 2006).
During spraying, most of farmers always and often did the unsafety pesticide
use behaviors in “smoking cigarettes nearby pesticide area” (M = 2.06, SD = 1.24),
“eating foods or drinking water nearby pesticide area” (M = 2.16, SD = 1.28), and
“wearing rubber boots to cover foots” (M = 2.17, SD = 1.23). This result accordance
with another finding, Palis et al. (2006) mentioned that most of farmers did not take
adequate protection from pesticides. The common reasons given for not doing safety
pesticide use behavior were too stifling, uncomfortable and can cause illness. In this
study, there are 62.4 %, 55.3 %, 73.5 % of respondents who worn normal glasses,
cotton gloves, worn short-sleeve shirt respectively. The reason for this is that farmers
had low knowledge about main route of exposure to pesticide. A half of them (51.2 %)
responded that main route of exposure to pesticide is through ingestion. Moreover,
81
they also felt hot or inconvenience when they worn PPE and the PPE inhibited their
work. In the other hands, farmer did not perceive benefits of adopting safety pesticide
use behavior especially PPE. Hence respondents do not pay attention in using PPE.
These things intended to farmers had bad behavior in getting safety pesticide use
behavior. These findings were in line with some researches. The farmers believed that
the main route of exposure was only through inhalation and ingestion (Acury et al.,
2002; Palis et al., 2006).
After spraying, even though farmers did the safety pesticide behavior but
most of farmers still had unsafe behaviors in using pesticide as the behaviors of
“changing spraying - clothes before arriving house” (M = 2.49, SD = 1.18),
“re-using the empty pesticide containers or bottles to store water or foods” (M = 2.56,
SD = 1.17), and “washing spraying - clothes with others” (M = 2.62, SD = 1.22).
Raksanam et al. (2013) also revealed that the pesticide use behaviors were unsafely.
The result can explain because that washed spraying-clothes wasted their time,
accounted for 44.1 % of respondents. In addition, half of participants (46.5 %) had
incorrect knowledge in storing pesticide method, and 41.2 % of them had incorrect
knowledge in re-use empty pesticide container/ bottle. In fact, have no special
company for disposal empty pesticide container/ bottle in Thai Nguyen city.
2. Factors correlated safety pesticide use behavior among farmers in
Thai Nguyen, Vietnam.
The result showed that knowledge of farmers in using pesticide, perceived
susceptibility to expose to pesticide, and perceived severity of consequences from
exposure to pesticide could predict safety pesticide use behavior. However, gender,
school education level, perceived benefits of adopting safety pesticide use behavior,
and perceived barriers to adopt safety pesticide use behavior were not the significant
predictors of safety pesticide use behavior.
Knowledge of farmer in using pesticide was the consistent with component
of the HBM to show the significant predictor of safety pesticide use behavior in this
study. MBM mentioned that knowledge level could indirectly influence health related
behavior, the higher knowledge, the more likely individual is to report a good
behavior (Glanz et al., 2002). In addition to knowledge of farmer in using pesticide
had a positive relationship with pesticide use behavior (β = .54, p < .001). This
82
indicates that the more knowledge, the more likely farmer is to report a safety
behavior in using pesticide. In the other hands, a farmer who has high knowledge of
farmer in using pesticide they will act to get safety pesticide use behavior. This result
was in line with some research revealed that if the farmers have good knowledge
about kind of pesticide and the health effect of pesticide they use, they will prevent
risky behavior in using pesticides (Mohanty et al., 2013; Suklim et al., 2013).
Perceived susceptibility to expose to pesticides was the significant factor.
In addition to perceived susceptibility, perceived severity and knowledge predict
safety pesticide use behavior. These variables could predict 53 % of variation in safety
pesticide use behavior. Moreover, perceived susceptibility had a significant positive
relationship with pesticide use behavior (β = .19, p < .01). This indicated that the more
perceived susceptibility, the more likely farmer is to report a good behavior. According
to the HBM, individual will act to avoid a health problem, but they first need to
believe they are personally susceptible to the problem. Individuals will take action to
control health behavior if they regard themselves as susceptibility to consequences of
behavior. (Glanz et al., 2002). Perceived susceptibility provided the energy to act
(Janz & Becker, 1984). Farmers generally were not perceived of potential hazards
related to pesticide use that might cause harm to them and their families (Wongwichit,
Siriwong, & Robson, 2012). The results showed that farmer participants had moderate
levels of health belief regarding pesticide exposure. In addition, Strong et al. (2008)
mentioned that performance of exposure prevention behaviors was significantly and
positively associated with perceived susceptibility (p = .001).
Perceived severity of consequence from exposure to pesticide was the
consistent component of the HBM to show the significant predictor of safety pesticide
use behavior in this study. HBM indicated that individuals take actions toward health
if they believe harm can be serious (Glanz et al., 2002). In addition to perceived
susceptibility and other variables could predict safety pesticide use behavior.
Moreover, perceived severity had was positive related with safety pesticide use
behavior (β = .16, p < .05). This indicates that the more perceived severity, the more
likely farmer is to report a good behavior. It implied that farmers who have high
perceived severity of consequences from exposure to pesticide will do safety behavior
more. This finding was accordance with some researcher viewed perceived severity of
83
consequences of exposure to pesticide was important factor in shaping individual’s
behavior. This factor is to convince farmer to take more protection. This evident
suggested that risk perception of farmer is low and they are less likely to take safety
behavior (Khan, Husnain, Mahmood, & Akram 2013). Raksanam (2011) also
mentioned that a high perceived severity of pesticide hazard was correspondingly high
risk pesticide use behaviors (β = .59, p < .005).
Perceived benefit to adopt the safety pesticide use behavior and perceived
barrier to do the safety pesticide use behavior were not significant predictors of
pesticide use behavior. The results could explain that maybe these variables were
affected by other variables resulted. Therefore, perceived benefit and perceived barrier
had not significant correlations with safety pesticide use behavior. In the other hands,
the HBM mentioned that the effects of perceived benefit and perceived barrier to
behavior were different with the way that perceived susceptibility and perceived
severity affected to a behavior even though four of them were the perceptions. In
context of HBM, the combined levels of susceptibility and severity provide the energy
or force to act and the perception of benefits (over barriers) provide a preferred path of
actions. Perceived benefits and perceived barriers were likelihood of action (Janz &
Becker, 1984). These were the reasons why perceived benefit and perceived barrier
were not significant predictor factors even though perceived susceptibility and
perceived severity were significant. The result accordance with another research
indicated that perceived benefits of adopting safety pesticide use behavior and
perceived barrier to do the safety pesticide use behavior were not significant predictors
of pesticide use behavior (β = - .01, p = .74; β = - .12, p = .053 respectively) (Raksanam
et al., 2012). The author mentioned that could not perceived benefits of safety
pesticide use behavior because the PPE and safe behavior method during pesticide
application were not the common practice in community. However, the study revealed
that farmers had perceived benefits at low level and perceived barriers at high level.
The results also indicated that gender and educational level of farmers had
the significant relationships with safety pesticide use behavior but could not predict
the safety pesticide use behavior in this study. In addition, gender and educational
level variables was affected by other variables resulted in these two variables were not
the significant predictors of safety pesticide use behavior. From literature, the role of
84
farmer’s gender and educational level are still being debated. Some researchers found
that gender and educational level had relationship with safety pesticide use behavior
(Khai & Yabe, 2012; Strong et al., 2008; Raksanam et al., 2012; Larkin et al., 2008).
But other researchers revealed that had no effect of school educational level on
behavior to pesticide use (Gaber & Litif, 2012; Zadjali et al., 2014). Farmer’s gender
had not influenced their practice on safety use of pesticides (Kumari & Reddy, 2013).
Added to that some studies showed that female farmer had higher level of pesticide
use behavior than male farmer (Salvatore et al., 2009) but in contrast, other studies
showed that male farmer had lower level of pesticide use behavior than female farmer
(Atreya, 2007; Lekei et al., 2014). The result of this study was in line with Hang
(2010). Even though, gender, educational level could not predict safety pesticide use
behaviors. But in fact, finding of this study showed that female farmer had higher
level of safety pesticide use behavior than male farmer and the farmer with high
school and higher degree had higher level of safety pesticide use behavior than farmer
with primary school and no-education.
Implications
Based on the research findings, there are suggestions as follow:
1. The implication for nursing practice. Firstly, the results of this study will
provide necessary information about real situation of the safety pesticide use behavior
among farmers. The safety pesticide use behavior was at a moderate level in this
study. This result also benefited for nurse and health care provider to indentify the
unsafe behavior in using pesticide. Nurse’s role should be prevention the unsafe
behavior in each step of pesticide application (specifically before, during and after
spraying pesticide). Secondly, contents of this study should be used as a guideline for
nurse and other health care provider to recognize level of farmer’s knowledge and
perceptions. This study showed that farmers ranged their knowledge and perception at
low and moderate level. Finding also revealed the incorrect knowledge and
perceptions. Nurse should increase the knowledge and perceptions of farmer by doing
nursing health education and counseling. Nurses should educate the severity of
consequences from exposure to pesticide, explain simply the reasons leading those
consequences occur and also harmful effects of bad behavior in using pesticide. It is
85
necessary to provide a standard guideline for farmer how to perform “safety pesticide
use behavior”.
2. The implication for administration/ policy. The finding of this study
showed that there were three variables could predict safety pesticide use behavior
(knowledge, perceived susceptibility to expose to pesticide, perceived severity of
consequence form pesticide exposure). At government and local level should
necessary to provide proper strategies to increase safety pesticide use behavior by
altering the influencing factors which have been identified in this study. There is a
need for regular safety training for farmer who had low knowledge in using pesticide,
low perceived susceptibility to expose to pesticide, low perceived severity of
consequences from exposure to pesticide, low perceived benefits of doing safety
pesticide use behavior and high perceived barrier to inhibit doing safety behavior.
Especially, government should conduct a project to provide the PPE, help them
understand benefit of using PPE and overcome the barrier that inhibited them to use
PPE, guideline to use this as well as provide a service to manage and dispose the
empty pesticide container/ bottle after using.
Recommendations for future research
1. The longitudinal studies are recommended since these would further
permit a more in-depth understanding of the safety pesticide use behavior and help to
examine factors influencing safety pesticide use behavior. The longitudinal study has
more power than a cross - sectional correlation design in the aspect of revealing
changes, developmental process, and causal explanation.
2. The intervention studies to increase pesticide use behavior were
recommended for future researches. The researches in the future should to focus on
predictors which were found from this study including knowledge, perceived
susceptibility, and perceived severity. In addition, we also should to pay attention on
group of male farmer and the farmer who had low level of education for future study.
86
Conclusion
The results of this study will provide basis knowledge and necessary
information for nurse and health care provider. Nurses should identify farmers who
had unsafe behavior of doing safety pesticide use behavior, incorrect knowledge in
using pesticide and low perceptions. They should develop a plan to increase safety
pesticide use behavior for farmer by focusing in important factors (knowledge in using
pesticide, perceived susceptibility, and perceived severity).
87
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99
APPENDICES
100
APPENDIX A
IRB approval and consent form
101
102
PARTICIPANT’S INFORMATION SHEET
Dear ………………
I am Mr. Hoang Trung Kien, a master student at the faculty of Nursing,
Burapha University, Thailand. My study entitled, “Factors influencing safety pesticide
use behavior among farmers in Thai Nguyen, Vietnam”. The objectives of this study is
to explore predictability of comorbidity, duration of gender, education, knowledge,
perception of farmers and safety pesticide use behavior among Vietnamese farmers.
This study will be a survey study. If you agree to participate in this study,
you will answer the following questionnaires which will take approximately 25
minutes. During the date collection, period, the researcher will clarity any question
posed by the participants for clarity regarding the language or content.
Participation is voluntary. You have the right to end your participation in this
study at any time without any penalty, and not necessary to inform the researcher. You
may refuse to answer any specific questions, remain silent, or leaves this study at any
time. Any information received from this study, including your identity, will be kept
confidential. According number will be assigned to you and your name will not used.
Findings from the study will be destroyed completely within 1 year after publishing
and presenting the findings. You will receive a further and deeper explanation of the
study upon its completion, if you wish.
The research will be conducted by Mr. Hoang Trung Kien under sypervision
of my major-addvisor, Assist. Prof. Dr. Chantana Chantawong. If you have any
question, plesase contact met at # telephone: (+84)978734176 or (+66)922198937 or
by email [email protected]. Your cooperation is greatly appreciated.
Please sign your name below to indicate your consent to participate in this
study. You will be given a copy of this consent form to keep.
Hoang Trung Kien
Researcher
103
INFORMED CONSENT
Title: “Factors influencing safety pesticide use behavior among farmers in Thai
Nguyen, Vietnam”
IRB approval number: ………………………….
Data of collection: February, 2015
Before I, as a participant, give signature in below, I already be informed and
explained from about purpose, method, procedures, and benefits of this study, and I
understood all of that explanation. I agree to be as a participant of this study.
I am Mr. Hoang Trung Kien, as a researcher, has explained all of explanation
about purposes, method, procedures, and benefits of this study to the participant with
honesty; than, all of data/information of the participants will only be used for purpose
of this research study.
_______________________ ______________________
Name and Signature of Participant Date
_______________________ ______________________
Name and Signature of witness Name and Signature of the reseacher
Hoang Trung Kien
104
APPENDIX B
Asking permission for data collection
105
106
107
108
APPENDIX C
List of experts for validity test
109
LIST OF EXPERT FOR VALIDITY TEST
1. Assoc. Prof. Dr. Suwanna Junprasert Community Nursing Group
Faculty of Nursing,
Burapha University
2. Assist. Prof. Yuwadee Leelukkanaveera Community Nursing Group
Faculty of Nursing,
Burapha University
3. Assist. Prof. Dr. Supaporn Duangpaeng Adult Nursing Group
Faculty of Nursing,
Burapha University
4. Assist. Prof. Capt. Dr.Chanudda Nabkasorn Psychiatric and Mental Health
Nursing Group
Faculty of Nursing,
Burapha University
5. Assoc. Prof. Dr. Sara Arphorn Department of Occupational
Health and Safety
Faculty of Public Health,
Mahidol University
110
APPENDIX D
Multiple regression assumption test
111
ASSUMPTION TEST
The assumption of regression analysis include randomness of dependent and
independent variable, normality of dependent and independent variables,
multicollinearity, linearity, autocorrelation and homoscedasticity were tested as
follows:
1. Normal distribution: The result of one-sample Kolmogorov-Smirnov test
indicated that safety pesticide use behavior, knowledge in using pesticide, and
perceptions of farmer were normally distributed (> .05).
2. Randomness: The result of runs test indicated that safety pesticide use
behavior, knowledge in using pesticide, and perceptions of farmer was random variable.
3. Multicollinearity: The Pearson correlation analysis showed that there were
no values greater than .85 in the Pearson correlation test. It indicated that no
multicollinearity for variables. In addition, from t-test result, tolerance values of all
independent variable was greater than .10, variance inflation factor (VIF) value is of all
independent variable was lesser than 10, that means no multicollinearity.
4. Linearity: The normal P-P plot of regression standardized residuals showed
the relationship between dependent variable with independent variables. The scatterplot
indicated variables were close to straight line.
5. Autocorrelation: The result of analysis showed that the Dubin-Watson
value was 2.01. It meat that no autocorrelation.
6. Homoscedasticity: The result of analysis in Scatterplot table showed that
the scatterplot between standardized predict value and standardized residual, it stayed in
a narrow space (- 3, + 3). Variance of Z residual across all values of Z predicted was
equally distributed. Variances were homoscedasticity. In addition, no data are beyond
the values of – 3 or + 3. There was no outlier.
112
APPENDIX E
Questionnaires (English and Vietnamese version)
113
Part 1: Demographic data
This questionnaire will be used to ask participants about their general
information and personal characteristic of participants. Please answer the questions in
the space provided or choose the answer by marking (√) in the relevant brackets. You
can choose only one answer.
1. Age ……………. (years)
2. Gender?
1) Male 2) Female
3. Marital status?
1) Married 2) Single 3) Widowed or Divorced
4. Education level?
1) Non education 4) High school
2) Primary school 5) Diploma
3) Secondary school 6) Bachelor and higher level
5. How long have you been farming in your field? ………………………….… Years
6. Monthly income?
1) < 1.500.000 VND
2) 1.500.000 - 3.000.000 VND
3) 3.000.000 - 5.000.000 VND
4) > 5.000.000 VND
7. Duration of insecticide use in each year? ………………………..…(Month/ year)
8. Frequency of using pesticides? ………………………….(Spraying time/ month)
9. Size of farming area? ...........................................................(Thousand miter square)
10. How many farmers in your family that use pesticides? ………………….(Person)
114
Part 2: Safety pesticide use behavior
The purpose of this study is to examine safety practice of participants in
using pesticide including before spraying pesticide, while spraying pesticide and after
spraying pesticide. The respondentmark (√) in the bracket, according totheir answer,
following criteria:
Always or usually done means the farmer practice preventive behavior
every time or 7 or more of 10 times for using pesticides
Often done means the farmer sometimes practice preventive behavior when
using pesticide 4 to 6 from 10 times of using pesticide
Sometime done means the farmer rarely practice preventive behavior when
he uses pesticide or doing 1 to 3 from 10 times of using pesticides.
Never done means the farmer never practice preventive behavior when
using pesticide
No Statements Frequency
How often do you …………………… Always
(4)
Often
(3)
Sometime
(2)
Never
(1)
Before spraying
1 Carry pesticide with water and foods
2 Read the direction on label
3 ……………………..
4 ……………………..
5 Wearing normal mask to cover mouth
and nose when mixing pesticide
6 ……………………..
7 ……………………..
8 ……………………..
9 ……………………..
10 ……………………..
11 Store pesticide in opened door and
inside house
115
No Statements Frequency
How often do you …………………… Always
(4)
Often
(3)
Sometime
(2)
Never
(1)
During spraying
12 Spraying follow wind’s direction
13 ……………………..
14 Wearing normal hat to cover head
15 ……………………..
16 ……………………..
17 ……………………..
18 ……………………..
19 ……………………..
20 ……………………..
21 Smoking cigarette near pesticide area
22 ……………………..
23 ……………………..
24 Blowing clogged nozzle by mouth
After spraying
25 ……………………..
26 ……………………..
27 Wash spraying - clothes with others
28 ……………………..
29 ……………………..
30 ……………………..
31 ……………………..
32 Return to the field immediately after
spraying pesticide
116
Part 3: Perceptions of farmer
The purpose of this questionnaire is to examine the belief of farmer about the
perceived severity of consequence from exposure to pesticide, perceived susceptibility
of consequence from exposure to pesticide, perceived benefit of adopting safety
behavior and perceived barrier to adopt safety behavior. Please mark (√) in the bracket
corresponding to your beliefs. You can choose only one answer.
3.1 Perceived susceptibility to poisoning from pesticide exposure
No Statements Perception level
How do you feel ……………………………...
Very
high
risky
(4)
High
risky
(3)
Low
risky
(2)
Very
low
risky
(1)
1 If you carry pesticide with water ………
2 ……………………..
3 ……………………..
4 ……………………..
5 ……………………..
6 If you spraying on strong wind and sunlight,
you could get poisoning
7 ……………………..
8 ……………………..
9 ……………………..
10 If you work with pesticide in long-term
11 If you having a good health
12 ……………………..
13 ……………………..
14 ……………………..
15 ……………………..
16 ……………………..
117
No Statements Perception level
How do you feel ……………………………...
Very
high
risky
(4)
High
risky
(3)
Low
risky
(2)
Very
low
risky
(1)
17
If you re-use empty pesticide containers/
bottle store other materials or foods, you
could …….
18 If you return to the field immediately after
spraying, you could get poisoning
3.2 Perceived severity of consequences of harmful expects from
pesticide exposure
No Statements Perception level
You belief that harmful effects from
pesticide exposure …………………
Very
high
serious
(4)
High
serious
(3)
Low
serious
(2)
Not at
all
serious
(1)
1.
Can cause nervous/sensory problems
(Headache; Dizziness etc) in short-
term
2. ……………………..
3. ……………………..
4. ……………………..
5. ……………………..
6. Can cause cardiovascular problems
(Chest pain etc) in short-term
7 Can cause cancer in long-term (lungs
and liver cancer)
8 ……………………..
118
No Statements Perception level
You belief that harmful effects from
pesticide exposure …………………
Very
high
serious
(4)
High
serious
(3)
Low
serious
(2)
Not at
all
serious
(1)
9 Damage to the immune system in
long-term (allergy)
10 ……………………..
11 ……………………..
12 ……………………..
13 Can cause economic burden
14 ……………………..
15 Can cause social interaction
16 ……………………..
3.3 Perceived benefits of adopting safety pesticide use behavior
No Statements Perception level
How do you feel if you……….
Very
high
benefit
(4)
High
benefit
(3)
Low
benefit
(2)
Very
low
benefit
(1)
1. Carry pesticide without water ………
2. ……………………..
3. Wearing PPE ………………………
4. ……………………..
5. ……………………..
6. ……………………..
7 ……………………..
8 ……………………..
119
No Statements Perception level
How do you feel if you……….
Very
high
benefit
(4)
High
benefit
(3)
Low
benefit
(2)
Very
low
benefit
(1)
9
Wash the hands after spaying
immediately help you
………………….
10 ……………………..
11 ……………………..
12 ……………………..
13
Inadequate disposal pesticide
contains/ bottle reducing water and
soil …………
3.4 Perceived barriers to adopt safety pesticide use behavior
No Statements Perception level
How much do you agree with the
following ………………………..
Strong
agree
(4)
Agree
(3)
Disagree
(2)
Strong
disagree
(1)
1. You feel no need to transport
pesticide without materials and food
2. ……………………..
3. ……………………..
4. ……………………..
5. ……………………..
6.
You feel wear personal protective
equipments while
………………….
120
No Statements Perception level
How much do you agree with the
following ………………………..
Strong
agree
(4)
Agree
(3)
Disagree
(2)
Strong
disagree
(1)
7
You feel waste the time to spray
pesticide follow the wind’s
direction
8 ……………………..
9 ……………………..
10 ……………………..
11 You do not how to dispose empty
pesticide container/ bottle
12 ……………………..
13 It save your money to re-use empty
container/ bottle to store other ……
Part 4: Knowledge of farmer on pesticide use
Purpose of this questionnaire is to examine the understanding of farmer
concerning the routes of exposure, harmful effects of from pesticide exposure and
safety practice in using pesticide. Instruction: Please select (/) for the best answer. You
can choose only one answer.
No Statement True
(2)
False
(1)
1 Main route of exposure to pesticides is through skin absorption
2 ……………………..
3 ……………………..
4 Exposure pesticides for long time is one of the cause of cancer
5 ……………………..
121
No Statement True
(2)
False
(1)
6 ……………………..
7 Wearing proper glasses while mixing and spraying can
pesticides protect absorption of pesticide into the body
8 ……………………..
9 ……………………..
10 ……………………..
11 Spraying pesticides in strong sunlight strong wind time can
protect absorption of pesticide into the body
12 ……………………..
13 ……………………..
14 ……………………..
15 ……………………..
16 The correct practice of pesticide use is immediately taking a
bath after working
17 ……………………..
18 ……………………..
19 ……………………..
20 Pesticide are one of the causes of water pollution and soil
contamination
122
Phần 1. Dữ liệu nhân khẩu học
Bộ câu hỏi này sẽ được sử dụng để hỏi người tham gia về những thông tin và
đặc điểm cơ bản của người tham gia nghiên cứu. Xin anh/chị vui long trả lời câu hỏi
bằng cách điền vào chỗ trống hoặc tích (√) vào ô vuông cho mỗi câu trả lời. Anh/chị
chỉ chọn duy nhất 1 đáp án cho mỗi câu trả lời.
1. Tuổi? ……………. (năm)
2. Giới tính?
1) Nam 2) Nữ
3. Tình trạng hôn nhân
1) Kết hôn 2) Độc thân 3) Đã ly dị
4. Trình độ văn hóa (bậc học cao nhất)?
1) Mù chữ 4) Cấp 3
2) Cấp 1 5) Trung cấp
3) Cấp 2 6) Đại học và trên đại học
5. Anh/ chị làm nghề nông được bao nhiêu năm? ………………………….… (năm)
6. Thu nhập bình quân trên tháng?
1) < 1.500.000 VND
2) 1.500.000 - 3.000.000 VND
3) 3.000.000 - 5.000.000 VND
4) > 5.000.000 VND
7. Anh/ chị phun thuốc trừ bao nhiêu lần/ tháng? ………..……...(số lần phun/ tháng)
8. Anh chị sử dụng thuốc trừ sâu bao nhiêu tháng/ năm? …………..…(số tháng/ năm)
9. Diện tích đất nông nghiêp của gia đình anh/ chị là bao nhiêu?.....(Nghìn mét vuông)
10. Bao nhiêu người trong gia đình anh/ chị tham gia phun thuốc sâu?……….(Người)
123
Phần 2. Hành vi sử dụng thuốc trừ sâu an toàn
Mục đích của bộ câu hỏi để khảo sát hành vi an toàn, bảo vệ sức khỏe của
người nông dân khi sử dụng thuốc trừ sâu, bao hành vi an toàn trước khi phun, trong
khi phun và sau khi phun. Anh/ chị vui lòng đánh dấu (√) vào ô trồng cho mỗi câu trả
lời theo những tiêu chí sau:
Luôn luôn thực hiện có nghĩa là anh/chị thực hiện hành vi an toàn để bảo
vệ sức khỏe trong tất cả những lần phun thuốc sâu hoặc từ 7/10 lần phun
Thường thực hiện có nghĩa là anh/chị thường thực hiện hành vi an toàn để
bảo vệ sức khỏe từ 4-6/ 10 lần phun
Thỉnh thoảng thực hiện có nghĩa là anh thình thoảng thực hiện hành vi an
toàn để bảo vệ sức khỏe từ 1-3/ 10 lần phun
Không bào giờ có nghĩa anh/chị không bào giờ thực hiện hành vi an toàn để
bào vệ sức khỏe trong tất cả các lần phun
TT Hành vi an toàn để bảo vệ sức khỏe Múc độ thực hiện
VD: Ông/bà thực hiện các công việc sau
như thế nào?
Luôn
luôn
(4)
Thường
xuyên
(3)
Thỉnh
thoảng
(2)
Không
bao
giờ
(1)
Trước khi phun
1. Chở thuốc trừ sâu cùng vơi nước và
thức ăn trước khi phun
2. ……………….
3. ……………….
4. ……………….
5. ……………….
6. Đeo khính bảo hộ kín mắt khi pha
thuốc trừ sâu trước khi phun
7. ……………….
8. ……………….
9. ……………….
124
TT Hành vi an toàn để bảo vệ sức khỏe Múc độ thực hiện
VD: Ông/bà thực hiện các công việc sau
như thế nào?
Luôn
luôn
(4)
Thường
xuyên
(3)
Thỉnh
thoảng
(2)
Không
bao
giờ
(1)
10. Đeo ủng kín chân khi pha thuôc trừ sau trước khi phun
11. ……………….
Trong khi phun
12. Phun thuốc trừ sâu theo hướng gió
13. ……………….
14. ……………….
15. ……………….
16. Đeo kính kín mắt khi phun
17. ……………….
18. Mặc áo bảo hộ lao động khi phun
19. ……………….
20. Đeo ủng kín chân khi phun
21. ……………….
22. ……………….
23. ……………….
24. Thổi vòi phun bị tắc bằng miệng
Sau khi phun
25. Rửa tây ngay sau khi phun
26. ……………….
27. ……………….
28. Thay quần áo bảo hộ trước khi vê nhà
29 ……………….
30 ……………….mương
31 ……………….
125
TT Hành vi an toàn để bảo vệ sức khỏe Múc độ thực hiện
VD: Ông/bà thực hiện các công việc sau
như thế nào?
Luôn
luôn
(4)
Thường
xuyên
(3)
Thỉnh
thoảng
(2)
Không
bao
giờ
(1)
32
Quay trở lại khu vực phun ngay lập
tức ngay sau khi mới phun thuốc trừ
sâu
Phần 3. Nhận thức của người nông dân
Mục đích của bộ câu hỏi là để khảo sát niềm tin của người nông dân về nhận hậu quả
nguy hiểm của việc phơi nhiễm thuốc trừ sâu, nhận thức tính dễ mắc, nhận thức lợi ích
của việc thự hiện hành vi an toàn, và rào càn để thự hiện hành vi an toàn khi sử dụng
thuốc trừ sâu. Anh/chị vui long đánh dấu (√) vào ô trống cho mỗi câu trả lời về niềm
tin của bạn thân. Chọn một câu trả lời duy nhất cho mỗi câu hỏi.
3.1 Nhận thức về khẳng năng dễ bị nhiễm độc từ việc phơi nhiễm với
thuốc sâu
TT Hành vi an toàn để bảo vệ sức khỏe Mức độ
Bạn nghĩ như thế nào.
Nguy
cơ rất
cao
(4)
Nguy
cơ cao
(3)
Nguy
cơ
thấp
(2)
Nguy
cơ rất
thấp
(1)
1. Nếu bạn vận chuyển thuốc trừ sâu cùng
với thức ăn, nước uống ………………….
2. ……………….
3. ……………….
4. ……………….
5. ……………….
6. ……………….
126
TT Hành vi an toàn để bảo vệ sức khỏe Mức độ
Bạn nghĩ như thế nào.
Nguy
cơ rất
cao
(4)
Nguy
cơ cao
(3)
Nguy
cơ
thấp
(2)
Nguy
cơ rất
thấp
(1)
7 Nếu bạn phun thuốc trừ sâu không có
thiết bị bảo hộ
8 ……………….
9 ……………….
10 ……………….
11 ……………….
12 ……………….
13 Nếu bạn không rửa tay hoặc tắm sau khi
phun thuốc, thuốc trừ sâu sẽ gấm vào cơ thể
14 ……………….
15 ……………….
16 Nếu bạn ném vỏ chai hoặc túi đựng thuôc
trừ sâu ra nơi công cộng
17 ……………….
18 ……………….
3.2 Nhận thức hậu quả nghiêm trọng từ việc phơi nhiễm với thuốc trừ
sâu
TT Hành vi an toàn để bảo vệ sức khỏe Mức độ
Bạn tin rằng ảnh hưởng có hại từ việc tiếp xúc
với thuốc trừ sâu
Rất
nguy
hiểm
(4)
Nguy
hiểm
cao
(3)
Ít
nguy
hiểm
(2)
Không
nguy
hiểm
(1)
1. Có thể gây ra các vấn để về thần kinh/cảm
127
TT Hành vi an toàn để bảo vệ sức khỏe Mức độ
Bạn tin rằng ảnh hưởng có hại từ việc tiếp xúc
với thuốc trừ sâu
Rất
nguy
hiểm
(4)
Nguy
hiểm
cao
(3)
Ít
nguy
hiểm
(2)
Không
nguy
hiểm
(1)
giác (đau đầu, chóng mặt, nhược cơ…)
2. ……………….
3. ……………….
4. ……………….
5. ……………….
6. Có thể gây ra các vấn đề về tim mạch
(đau ngưc, tim đập nhanh)
7 Có thể gây ra ung thư trong thời gian dài
8 ……………….
9 ……………….
10 Giảm chất lượng tinh trùng ở nam giới
11 ……………….
12 ……………….
13 ……………….
14 Có thể gây ra gánh nặng cho gia đình
15 ……………….
16 ……………….
128
3.3 Nhận thực lợi ích của việc thực hiện hành vi an toàn để bảo vệ sức khỏe
TT Hành vi an toàn để bảo vệ sức khỏe Mức độ
Bạn nghĩ như thế nào nếu bạn
Very
high
benefit
(4)
High
benefit
(3)
Low
benefit
(2)
Very
low
benefit
(1)
1. Không vận chuyển thuốc trừ sâu cùng
2. ……………….
3. ……………….
4. ……………….
5. ……………….
6. Mặc đồ bảo hộ giúp bạn tránh ngộ độc
7 ……………….
8 ……………….
9 Rửa tay ngay sau khi phun thuốc sâu
giúp bạn duy trì sức khỏe
10 ……………….
11 ……………….
12 ……………….
13 Sử lý chai lọ, thùng chứa thuốc trừ sâu
hợp lý làm giảm ô nhiễm đất trồng
129
3.4 Nhận thức rào cản để thực hiện hành vi sử dụng thuốc trừ sâu an
toàn
TT Hành vi an toàn để bảo vệ sức khỏe Mức độ
Bạn động ý như thế nào vơi những điều dưới
đây
Rất
đồng
ý
(4)
Đồng
ý
(3)
Không
đồng ý
(2)
Rất
không
đồng ý
(1)
1. Bạn nghĩ rằng chở thuốc trừ sâu cùng với
nước và thức ăn là thuận tiện và tiết kiệm
2. ……………….
3. ……………….
4. ……………….
5. Bạn cảm thấy nóng và không thoải mái
6. ……………….
7 ……………….
8 Bạn nghĩ rằng bạn sẽ tiết kiệm thời gian
nếu bạn ăn uống
9 ……………….
10 ……………….
11 ……………….
12 ……………….
13
Bạn nghĩ rằng bạn sẽ tiết kiệm được tiền
bạc khi bạn tái sử dụng chai lọ nước và
thức ăn
130
Phần 4. Kiến thức người nông dân về sử dụng thuốc trừ sâu an toàn
Mục đích của bộ câu hỏi là để xác định sự hiểu biết của người nông đân
quan tâm đến các con đường phơi nhiễm, tác dụng có hại từ việc phơi nhiễm thuốc trừ
sâu và thực hiện hành vi an toàn trong việc sử dụng thuốc trừ sâu.
Hướng dẫn trả lời: Anh/chị vui long đánh dấu (/) cho mỗi câu trả lời mà anh chị thấy
đúng nhất. Chọn duy nhất một câu trả lời cho mỗi câu hỏi
TT Kiến thức đúng sai
1 ……………….
2 Thuốc trừ sâu có thể gây hại cho con người
3 ……………….
4 Phơi nhiễn với thuốc trừ sâu trong thời gian dài là một trong
những nguyên nhân gây ra ung thư
5 ……………….
6 ……………….
7 ……………….
8 Đeo khẩu trang khi pha trộn và khi phun thuốc trừ sâu có thể
phòng tránh sự hấp thu thuốc trừ sâu vào cơ thể
9 ……………….
10 ……………….
11 Phun thuốc trừ sâu trong điều kiện nắng gắt và gió to có thể
phòng tránh sự hấp thu của thuốc trừ sâu vào cơ thể
12 ……………….
13 ……………….
14 ……………….
15
Phương pháp thực hành đúng trong việc sử dụng thuốc trừ sâu
đó là đưa chai lọ, thùng chữa thuốc trừ sâu đã qua sử dụng đến
công ty chuyên sử lý chất thải
16 ……………….
17 ……………….
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TT Kiến thức đúng sai
18 Hút thuốc lá, ăn uông trong khi phun sẽ làm tăng nguy cơ hấp
thu thuốc trừ sâu vào cơ thể
19 ……………….
20
Pesticide is one of the causes of water pollution and soil
contamination
Thuốc trừ sâu là một trong những nguyên nhân của ô nhiễm
nước và cây trồng